Individual provider Active NPI

James E. Wilson, M.D.

  • Interventional Pain Medicine Physician
  • Naperville, IL
National Provider Identifier
1265490239
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
036078688 Issued in IL
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

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
036078688MedicaidIL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040320000617 IL Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 6305747718 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036078688ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oswego Family Chiropractic Center, P.C. CurrentSince May 1, 2014 Accepting new patients
Oak Brook Medical Group LTD CurrentSince Apr 1, 2022 Accepting new patients
Advanced Health Medical LTD CurrentSince Jun 1, 2021 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.