Pai Participant 27, PC
Organization Active NPI Geriatric Medicine (Internal Medicine) Physician · Willowbrook, IL
NPI 1093398539 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1093398539
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- Legal business name
- PAI PARTICIPANT 27, PC
- Practice address
- 7050 S Madison St
Willowbrook, IL 60527-5548 - Phone
- (630) 323-6380
- NPI assigned
- May 3, 2021
- Organization subpart
- No
Authorized official
- Name
- Brittain Brantley
- Title
- Acting President
- Phone
- (302) 300-5138
Practitioners 17
-
Katherine Anne Burnley, ANP-C
-
Mary E Maloney, ANP
-
Kayla Rokey, DNP-FNP
-
Emil Fernando, MD
-
Kayla Catherine Carlile, FNP-BC
-
Sarah Maas, APN, FNP-BC
-
Danielle Pagano, APN
-
Marsha Rochelle Johnson, ACNP
-
Walter Lin, MD, MBA
-
Michelle M Burk, DO
-
Jill Lorraine Wright, APRN
-
Omer Yusaf, MD
-
Robert B Maguire, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210614001032 | IL | Part B Supplier - Clinic/Group Practice | 2668872672 |
Receives reassigned benefits from 16 practitioners Practice locations: Ottawa, IL; Waterloo, IL; Vernon Hills, IL; Mendota, IL; Belleville, IL; Glen Carbon, IL; La Salle, IL; Alton, IL |
National Provider Directory
Locations
27 Auerbach Pl
Glen Carbon, IL 62034
Phone (618) 277-3700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X | Yes |
Addresses
Primary practice location
7050 S Madison St
Willowbrook, IL 60527-5548
Mailing address
PO Box 639676
Cincinnati, OH 45263-9676
Phone (859) 291-4800
Other providers in Willowbrook, IL
- Osteopathic Manipulative Healthcare, S.C.
- Osteopathic Sports Medicine, S.C.
- Sam-Uche Ozokwo
- Leszek Zenon Paczkowski
- Nalda Helen Page
- D. Anaya Palay
- Daniel Elias Palos
- Panicker Internal Medicine Inc
- Maria Pappas
- Sangtae Park
All providers in Willowbrook, IL · Geriatric Medicine (Internal Medicine) Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.