Individual provider Active NPI

Justine N. Wilson, APN-CNP

  • Nurse Practitioner
  • Woodridge, IL
National Provider Identifier
1073180188
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209023531 Issued in IL
Practice address
3329 75TH St Ste 200
Woodridge, IL 60517-2700
Phone
(630) 964-9400
Fax
(630) 964-9375
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209023531 IL Primary
Family Nurse Practitioner 363LF0000X 209023531 IL

Addresses

Primary practice location

3329 75TH St Ste 200
Woodridge, IL 60517-2700

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 982-6715

Other names 1

  • Justine Nicole Wilson Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210805003164 IL Practitioner - Nurse Practitioner 0749684280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 12, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 12, 2023 Accepting new patients
Edward Health Ventures CurrentSince Oct 1, 2021 Accepting new patients
Edward Health Ventures CurrentSince Oct 1, 2021 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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

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

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

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

3329 75th St
Ste 200
Woodridge, IL 60517
Phone (630) 694-9400

3540 Seven Bridges Dr
Ste 230
Woodridge, IL 60517
Phone (630) 964-9400

Interoperability endpoints

  • Direct secure messaging: jwilson178160@direct.edward.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1073180188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3329 75TH ST STE 200",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172700",
            "telephone_number": "630-964-9400",
            "fax_number": "630-964-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JUSTINE",
        "middle_name": "N.",
        "name_prefix": "Mrs.",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209023531",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "WILSON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodridge, IL

Sources for this page

Verify at the official NPI Registry.