NPIMap

Individual provider Active NPI

Seema R Mamtora, PA-C

  • Physician Assistant
  • Oak Brook, IL
National Provider Identifier
1043509607
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004008 Issued in IL
Practice address
1001 Commerce Dr Ste 700
Oak Brook, IL 60523-8865
Phone
(312) 732-4490
Fax
(312) 732-4491
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085004008 IL
Physician Assistant 363A00000X 085004008 IL Primary

Addresses

Primary practice location

1001 Commerce Dr Ste 700
Oak Brook, IL 60523-8865

Mailing address

1001 Commerce Dr Ste 700
Oak Brook, IL 60523-8865
Phone (312) 732-4490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110923000397 IL Practitioner - Physician Assistant 9537330543 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1001 Commerce Dr
Oak Brook, IL 60523-8865

233 S Gary Ave
Bloomingdale, IL 60108-2213
Phone (630) 358-4414

235 S Gary Ave
Suite 100
Bloomingdale, IL 60108-2213
Phone (630) 893-9600

2900 Foxfield Rd
Suite 100
St Charles, IL 60174-5799
Phone (630) 377-6500

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

7 Blanchard Cir
Wheaton, IL 60189-2038

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085004008ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Sep 6, 2022 Accepting new patients
Edward Health Ventures CurrentSince Sep 6, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 11, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 5, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 5, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

1001 Commerce Dr
Ste 700
Oak Brook, IL 60523
Phone (312) 732-4490

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1043509607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COMMERCE DR STE 700",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238865",
            "telephone_number": "312-732-4490",
            "fax_number": "312-732-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COMMERCE DR STE 700",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238865",
            "telephone_number": "312-732-4490",
            "fax_number": "312-732-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMTORA",
        "first_name": "SEEMA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004008",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.