Mark Whitney, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-005096 Issued in IL

Practice address

1815 Mediterranean Dr Ste 103
Sycamore, IL 60178-3299

Phone

(815) 981-4742

NPI assigned

Jul 22, 2014

Last updated

Dec 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24314/brand/2/csg/1/fhir/r4
• Direct secure messaging: mark.whitney.1@24314.direct.athenahealth.com

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.

• Gilvydis Vein Clinic, LTD.

  • Vascular & Interventional Radiology Physician
  • Sycamore, IL
  • NPI 1508104068
  Medicare reassignment
• Swedishamerican Hospital

  dba SwedishAmerican Medical Group

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1962451732
  Medicare reassignment
• Swedishamerican Hospital

  • Community/Retail Pharmacy
  • Rockford, IL
  • NPI 1306635982
  NPD
• Swedishamerican Hospital

  • Family Medicine Physician
  • Davis Junction, IL
  • NPI 1407908189
  NPD
• Northern Illinois Vein Clinic, LLC

  • Diagnostic Radiology Physician
  • Rockford, IL
  • NPI 1407824022
  NPD (past)

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1225445273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 MEDITERRANEAN DR STE 103",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783299",
            "telephone_number": "815-981-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 MEDITERRANEAN DR STE 103",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783299",
            "telephone_number": "815-981-4742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2631 Williamsburg Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601341111",
            "country_code": "US",
            "telephone_number": "630-345-3463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wells and Associates Wellness Center
• Philip A. Wells, MSN, LCSW
• Wellspring Center for Counseling, LLC
• Alisha M Wesley, MSN, CNM, APRN
• Timothy Rion Westergren, PHARMD
• Nichole Elizabeth Wiepert, M.D.
• McKenzie Wilkins, LCSW
• Jennifer Williams, D.D.S.
• Sarah Williams, M.A.
• Alexa Anne Williamson

• Physician Assistant in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.