Individual provider Active NPI

Jasmine Wenker, PA

  • Physician Assistant
  • Streamwood, IL
National Provider Identifier
1124718960
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009870 Issued in IL
Practice address
135 E Irving Park Rd
Streamwood, IL 60107-2950
Phone
(844) 599-3700
NPI assigned
May 15, 2023
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.009870 IL Primary

Addresses

Primary practice location

135 E Irving Park Rd
Streamwood, IL 60107-2950

Mailing address

135 E Irving Park Rd
Streamwood, IL 60107-2950

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
I20231207000828 IL Order and Referring Only - Physician Assistant 2264881911

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.009870ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Family Health Past Accepting new patients
Greater Family Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jasmine.hinds.p1@direct.gefcc.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1124718960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072950",
            "telephone_number": "844-599-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENKER",
        "first_name": "JASMINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

Verify at the official NPI Registry.