D'Andra Mixon-Walker, PA-C
Individual provider Active NPI Physician Assistant · Summit, IL
NPI 1285375188 · NPPES record last updated Apr 5, 2022
Key facts
- NPI
- 1285375188
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 7450 W 63Rd St
Summit, IL 60501-1816 - Phone
- (708) 458-0757
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Community Health Network
Practice addresses (Care Compare)
3202 W N Ave
Humboldt Family Health Center
Chicago, IL 60647-4940
Phone (773) 278-1880
6020 W Diversey Ave
BLDG West
Chicago, IL 60639-1108
Phone (773) 237-5544
7450 W 63Rd St
Des Plaines Valley Family Health Center
Summit, IL 60501-1816
Phone (708) 458-0757
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230117002429 | IL | Practitioner - Physician Assistant | 7618348350 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Network | Current |
Accepting new patients | |
| Access Community Health Network | Current |
Accepting new patients | |
| Access Community Health Network | Past | Accepting new patients |
Locations
600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000
6020 W Diversey Ave
Bldg W
Chicago, IL 60639
Phone (773) 237-5544
3202 W North Ave
Chicago, IL 60647
Phone (773) 278-1880
7450 W 63rd St
Summit Argo, IL 60501
Phone (708) 458-0757
Interoperability endpoints
- dmixonwalker20637@direct.achn.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
7450 W 63Rd St
Summit, IL 60501-1816
Mailing address
1724 E 36TH Ave
Denver, CO 80205-4033
Phone (720) 327-0122
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dandra.mixonwalker@achn.net | Direct |
Other providers in Summit, IL
- Annemarie Luperini
- Mark Anthony Maciuszek
- Tiara Magee
- Mark J. Gagnon, LTD
- Metropolitan Health Care Providers LLC
- Mobile Lab Services Co
- Jennifer Osagie
- Carolyn M Para
- Pillars Community Health
- Mike Price
All providers in Summit, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.