Active NPI
Bonnie Lane Woeltjen, PA-C
- Surgical Physician Assistant
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 085006025
- Practice address
- 1942 W Fullerton Ave
Chicago, IL 60614-1894 - Phone
- (847) 866-7846
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA03492 | TX | |
| Surgical Physician Assistant | 363AS0400X | 085006025 | IL | Primary |
Addresses
Primary practice location
1942 W Fullerton Ave
Chicago, IL 60614-1894
Mailing address
2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Other practice location 1
6560 Fannin St
Scurlock Tower, Suite 400
Houston, TX 77030-2761
Phone (713) 441-9000
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01068934 | Other | TX | RR MEDICARE |
| 616771101 | Other | US DEPT OF LABOR | |
| P00278999 | Other | TX | RAILROAD MEDICARE |
| 616771110 | Other | US DEPT OF LABOR | |
| 331364501 | Medicaid | TX | |
| 616771105 | Other | US DEPT OF LABOR | |
| 8N8791 | Other | TX | BLUE CROSS BLUE SHIELD |
| P01253331 | Other | TX | MEDICARE RR |
| 601771109 | Other | US DEPT OF LABOR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2650 Ridge Ave
Evanston, IL 60201-1700
680 N Lake Shore Dr
Suite 924
Chicago, IL 60611-8701
Phone (312) 664-6848
9600 Gross Point Rd
Skokie, IL 60076-1214
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.9 of 100
- Quality
- 75.91
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085006025 | IL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| TMH Physician Organization | Past | Accepting new patients | |
| Tmhpo Orthopedics Department | Past | Accepting new patients |
Locations
9532 Eagle Way
Chicago, IL 60678
1942 W Fullerton Ave
Chicago, IL 60614
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175
Interoperability endpoints
- bwoeltjen20812@directhoustonmethodist.org
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.
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
-
- Family Medicine Physician
- Houston, TX
- NPI 1831862291
-
- Orthopaedic Trauma Physician
- Houston, TX
- NPI 1497795272
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774483200000",
"number": "1316983794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE STE 1223",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1942 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606141894",
"telephone_number": "847-866-7846"
}
],
"practiceLocations": [
{
"address_1": "6560 Fannin St",
"address_2": "Scurlock Tower, Suite 400",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770302761",
"country_code": "US",
"telephone_number": "713-441-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOELTJEN",
"first_name": "BONNIE",
"middle_name": "LANE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2026-03-26",
"certification_date": "2026-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA03492",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": "085006025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01068934",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "616771101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00278999",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "616771110",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "331364501",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "616771105",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8N8791",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P01253331",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "601771109",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.