Individual provider Active NPI

Debra Smalley, PA-C

  • Physician Assistant
  • St Charles, IL
National Provider Identifier
1184136996
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006436 Issued in IL
Practice address
2900 Foxfield Rd Ste 100
St Charles, IL 60174-5799
Phone
(630) 377-6500
Fax
(630) 377-6577
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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 085006436 IL Primary

Addresses

Primary practice location

2900 Foxfield Rd Ste 100
St Charles, IL 60174-5799

Mailing address

2900 Foxfield Rd Ste 100
St Charles, IL 60174-5799
Phone (630) 377-6500

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
I20171226000793 IL Practitioner - Physician Assistant 8426316316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1001 Commerce Dr
Oak Brook, IL 60523-8865

10350 Haligus Rd
Huntley, IL 60142-9545

1333 W Belmont Ave
Chicago, IL 60657-5785

15300 W Ave
Orland Park, IL 60462-4600

21202 Owens Rd
Suite 101
Mokena, IL 60448-2001
Phone (630) 315-6930

233 S Gary Ave
Bloomingdale, IL 60108-2213
Phone (630) 358-4414

235 S Gary Ave
Suite 100
Bloomingdale, IL 60108-2213
Phone (630) 893-9600

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

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

2900 Foxfield Rd
Suite 100
St Charles, IL 60174-5799
Phone (630) 377-6500

525 Rockland Rd
Lake Bluff, IL 60044-1778

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

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

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

7 Blanchard Cir
Wheaton, IL 60189-2038

820 Route 59
Barlett, IL 60103-1694
Phone (630) 213-9600

820 S Il Route 59
Suite 320
Bartlett, IL 60103-1694
Phone (630) 225-2663

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 23, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 23, 2019 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

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

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

Dept 5777
Carol Stream, IL 60122

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

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

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

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

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

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

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

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

7 Blanchard Cir
Ste 102
Wheaton, IL 60189
Phone (630) 510-9009

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": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1184136996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD STE 100",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "630-377-6500",
            "fax_number": "630-377-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD STE 100",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "630-377-6500",
            "fax_number": "630-377-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLEY",
        "first_name": "DEBRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.