Individual provider Active NPI

Jennifer D Wesselman-Williams, NP

  • Nurse Practitioner
  • Maryville, IL
National Provider Identifier
1073843967
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209007965 Issued in IL
Practice address
2236 Vadalabene Dr
Maryville, IL 62062-5844
Phone
(618) 726-2229
Fax
(618) 726-2225
NPI assigned
Dec 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 209007965 IL
Nurse Practitioner 363L00000X 209007965 IL Primary

Addresses

Primary practice location

2236 Vadalabene Dr
Maryville, IL 62062-5844

Mailing address

787 Sunset Blvd
O Fallon, IL 62269-1960
Phone (618) 726-2229

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
I20100528000377 IL Practitioner - Nurse Practitioner 8022147149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Southern Illinois University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christina H Dothager MD, LLCGroup PAC ID 9931458791, 4 clinicians

Practice addresses (Care Compare)

787 Sunset Blvd
Suite 200
O Fallon, IL 62269-1960
Phone (618) 726-2229

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209007965ILMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christina H Dothager MD LLC CurrentSince Mar 1, 2026 Accepting new patients

Locations

787 Sunset Blvd
#200
O Fallon, IL 62269
Phone (618) 624-2400

Organizations & group practices 1

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 1

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": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1073843967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 SUNSET BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691960",
            "telephone_number": "618-726-2229",
            "fax_number": "618-726-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625844",
            "telephone_number": "618-726-2229",
            "fax_number": "618-726-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSELMAN-WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-28",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209007965",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209007965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.