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DR. WALTER TATCH
NPI 1285714568
Oral & Maxillofacial Surgery in Gurnee, IL

Active since October 17, 2006Opted out of Medicare · through Dec 14, 2027
310 S GREENLEAF ST STE 203, GURNEE, IL 60031(847) 623-5915(847) 623-1174 Get Directions Write a Review

NPPES record last updated: December 16, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 16, 2024, Feb 5, 2024 (2 updates tracked since 2024).

About Dr. Walter Tatch NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WALTER TATCH (NPI 1285714568) is an individual oral & maxillofacial surgery provider in Gurnee, Illinois, licensed in Illinois (021002076) and active in the NPI registry since October 2006. He has opted out of Medicare through December 14, 2027 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1285714568
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. WALTER TATCH
Location Address310 S GREENLEAF ST STE 203Gurnee, IL 60031-5708
Mailing Address700 Osterman AveDeerfield, IL 60015-4375 · (847) 623-5915 · Fax (847) 623-1174
Phone(847) 623-5915
Fax(847) 623-1174
Sole ProprietorYes
Enumeration DateOctober 17, 2006
Last NPPES UpdateDecember 16, 20242 updates tracked since enumeration
NPPES CertifiedDecember 16, 2024
✔ NPI 1285714568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in IL · 021002076
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 021002076 (IL)
310 S GREENLEAF ST STE 203, Gurnee, IL 60031
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Secondary Practice Locations 2

Location 11900 Hollister Dr Ste 280Libertyville, IL 60048-5260 · Phone (847) 623-5915
Location 2700 Osterman AveDeerfield, IL 60015-4375 · Phone (847) 623-5915

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Walter Tatch has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 14, 2015 through December 14, 2027.

Opt-Out Effective DateDecember 14, 2015
Opt-Out In Effect ThroughDecember 14, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WALTER TATCH, D.D.S., LTD.
Dentist (Oral and Maxillofacial Surgery)
310 S GREENLEAF ST STE 203
GURNEE, IL 60031
Lake County (847) 623-5915
DR. TARAS MARTYNIOUK D.M.D.
Dentist (Oral and Maxillofacial Surgery)
310 S GREENLEAF ST STE 203
GURNEE, IL 60031
Lake County (847) 623-5915

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walter Tatch's NPI number?

The NPI number for Walter Tatch is 1285714568. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Where is Walter Tatch located?

Walter Tatch practices at 310 S Greenleaf St Ste 203, Gurnee, IL 60031. The listed phone number is (847) 623-5915.

What is Walter Tatch's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Walter Tatch enrolled in Medicare?

No. Walter Tatch has opted out of Medicare through December 14, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Walter Tatch was last updated on December 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.