Individual provider Active NPI

Robyn Wall, PA-C

  • Physician Assistant
  • Glenview, IL
National Provider Identifier
1134515992
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.005923 Issued in IL
Practice address
2701 Patriot Blvd
#110
Glenview, IL 60026-8039
Phone
(708) 642-7359
NPI assigned
Apr 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 085.005923 IL Primary

Addresses

Primary practice location

2701 Patriot Blvd
#110
Glenview, IL 60026-8039

Mailing address

2701 Patriot Blvd
#110
Glenview, IL 60026-8039
Phone (708) 642-7359

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
I20161118000278 IL Practitioner - Physician Assistant 6800175670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10350 Haligus Rd
Huntley, IL 60142-9545

1333 W Belmont Ave
Chicago, IL 60657-5785

1630 Sherman Ave
Evanston, IL 60201-3711

2635 Church Rd
Suite 101
Aurora, IL 60502-8943
Phone (630) 315-6900

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 998-9910

360 Station Dr
Crystal Lake, IL 60014-7978
Phone (815) 788-7500

4445 W Irving Park Rd
Chicago, IL 60641-2808

515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870

6155 Grand Ave
Gurnee, IL 60031-1651

635 N Fairbanks CT
FL 1
Chicago, IL 60611-5435
Phone (312) 472-3173

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.005923ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Nov 21, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 21, 2016 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations (25 of 26)

2635 Church Rd
Ste 101
Aurora, IL 60502
Phone (630) 315-6900

820 S State Route 59
Bartlett, IL 60103
Phone (630) 213-9600

231 S Gary Ave
Ste 100
Bloomingdale, IL 60108
Phone (630) 893-9600

Dept 5777
Carol Stream, IL 60122

4445 W Irving Park Rd
Ste 110
Chicago, IL 60641
Phone (312) 921-0417

1135 S Delano Ct E
Ste B201
Chicago, IL 60605
Phone (312) 694-2500

1333 W Belmont Ave
Ste 100
Chicago, IL 60657
Phone (312) 693-2273

171 N Aberdeen St
Ste 100
Chicago, IL 60607
Phone (312) 694-2273

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

360 Station Dr
Ste 300A
Crystal Lake, IL 60014
Phone (815) 788-7500

350 S Waukegan Rd
Ste 150
Deerfield, IL 60015
Phone (312) 926-3107

1630 Sherman Ave
Ste 130
Evanston, IL 60201
Phone (224) 271-4400

885 Roosevelt Rd
Ste 100
Glen Ellyn, IL 60137
Phone (630) 384-6200

2701 Patriot Blvd
#110
Glenview, IL 60026
Phone (708) 642-7359

2701 Patriot Blvd
Ste 110
Glenview, IL 60026
Phone (312) 694-2273

10350 Haligus Rd
Ste A
Huntley, IL 60142
Phone (815) 455-6100

525 Rockland Rd
Ste 100
Lake Bluff, IL 60044
Phone (847) 475-2273

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2507 N Richmond Rd
Ste B
McHenry, IL 60051
Phone (815) 206-7500

21202 Owens Rd
Ste 101
Mokena, IL 60448
Phone (779) 334-0030

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

636 Raymond Dr
Ste 107
Naperville, IL 60563
Phone (630) 359-8396

15300 West Ave
Ste 20
Orland Park, IL 60462
Phone (708) 460-5550

2900 Foxfield Rd
Ste 100
St Charles, IL 60174
Phone (630) 377-6500

870 N Milwaukee Ave
Vernon Hills, IL 60061
Phone (847) 475-2273

Organizations & group practices 3

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 4

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1134515992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 PATRIOT BLVD",
            "address_2": "#110",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268039",
            "telephone_number": "708-642-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PATRIOT BLVD",
            "address_2": "#110",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268039",
            "telephone_number": "708-642-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "ROBYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.