Active NPI
James E. Wilson, M.D.
- Interventional Pain Medicine Physician
- Naperville, IL
National Provider Identifier
1265490239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- 036078688
- Practice address
- 101 E 75TH St
Suite 110
Naperville, IL 60565-1469 - Phone
- (877) 873-7546
- Fax
- (877) 893-7546
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036078688 | IL | |
| Interventional Pain Medicine Physician | 208VP0014X | 036078688 | IL | Primary |
Addresses
Primary practice location
101 E 75TH St
Suite 110
Naperville, IL 60565-1469
Mailing address
101 E 75TH St
Suite 110
Naperville, IL 60565-1469
Phone (877) 873-7546
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036078688 | Medicaid | IL |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040320000617 | IL | Practitioner - Interventional Pain Management | 6305747718 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036078688 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oswego Family Chiropractic Center, P.C. | Current | Accepting new patients | |
| Oak Brook Medical Group LTD | Current | Accepting new patients | |
| Advanced Health Medical LTD | Current | Accepting new patients | |
| Advanced Pain Centers, S.C. | Interventional Pain Medicine | Past | Accepting new patients |
Locations
1147 S Wabash Ave
Ste 250B
Chicago, IL 60605
Phone (312) 987-4878
2603 W 22nd St
Ste 22
Oak Brook, IL 60523
Phone (630) 317-7478
1144 Douglas Rd
Oswego, IL 60543
Phone (630) 554-9323
Interoperability endpoints
- https://api.platform.athenahealth.com/14289/brand/1/csg/1/fhir/r4
Organizations & group practices 4
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.
-
- Chiropractor
- Oswego, IL
- NPI 1396878161
-
- Interventional Pain Medicine Physician
- Hoffman Estates, IL
- NPI 1487609202
Interventional Pain Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233100800000",
"number": "1265490239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E 75TH ST",
"address_2": "SUITE 110",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605651469",
"telephone_number": "877-873-7546",
"fax_number": "877-893-7546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E 75TH ST",
"address_2": "SUITE 110",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605651469",
"telephone_number": "877-873-7546",
"fax_number": "877-893-7546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JAMES",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2009-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036078688",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "IL",
"license": "036078688",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036078688",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.