Individual provider Active NPI

Patrica P Wyhinny, MD

  • Dermatology Physician
  • Des Plaines, IL
National Provider Identifier
1104891506
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036064685 Issued in IL
Practice address
8901 Golf Rd
206
Des Plaines, IL 60016-6850
Phone
(847) 699-1801
Fax
(847) 699-1744
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036064685 IL Primary

Addresses

Primary practice location

8901 Golf Rd
206
Des Plaines, IL 60016-6850

Mailing address

8901 Golf Rd
206
Des Plaines, IL 60016-6850
Phone (847) 699-1801

Other identifiers 1

IdentifierTypeStateIssuer
036064685MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001502 IL Practitioner - Dermatology 6103942081 Practice locations: Des Plaines, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Retina Consultants, S.C. PastSince Mar 13, 1998 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1104891506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 GOLF RD",
            "address_2": "206",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166850",
            "telephone_number": "847-699-1801",
            "fax_number": "847-699-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 GOLF RD",
            "address_2": "206",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166850",
            "telephone_number": "847-699-1801",
            "fax_number": "847-699-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYHINNY",
        "first_name": "PATRICA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036064685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064685",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.