Wimol Ann Mitrakul, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036111456 Issued in IL

Practice address

1239 Windham Pkwy
Romeoville, IL 60446-1608

Phone

(815) 942-6323

Fax

(779) 210-5541

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Rush Medical College of Rush University, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• IL HMO C-SNP
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• IL PPO Downstate
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Interoperability endpoints

• Direct secure messaging: wmitrakul205872@dulyhealthandcare.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• Cardiology Associates of Northern Illinois

  • Cardiovascular Disease Physician
  • Joliet, IL
  • NPI 1710145578
  NPD (past)
• Corwin Medical Care LTD

  • Primary Care Clinic/Center
  • Plainfield, IL
  • NPI 1174673826
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1013066257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770264",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 WINDHAM PKWY",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461608",
            "telephone_number": "815-942-6323",
            "fax_number": "779-210-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRAKUL",
        "first_name": "WIMOL",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wmitrakul205872@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1239 Windham Pkwy",
            "city": "Romeoville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604461608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary E Miller, L.S.W.
• Virgil Henry Miller III, D.C.,LAC
• Debbie Ann Miranda, BCBA
• Nicolette Rose Mireles, LCPC
• Jayme Mitchell, PA-C
• Rima Modi, DMD
• Gabriella Moran
• Katherine Moudry, DPT
• Andy K Moy, DT
• Daniel Moynihan, D.C.

• Family Medicine Physician in Romeoville, IL
• Providers in Romeoville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.