Individual provider Active NPI

Denise Rena Wilson, APN

  • Adult Health Clinical Nurse Specialist
  • Homer Glen, IL
National Provider Identifier
1346674579
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
277000402 Issued in IL
Practice address
15929 S Bell Rd
Homer Glen, IL 60491-6707
Phone
(708) 745-5600
Fax
(815) 300-3778
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 277000402 IL Primary

Addresses

Primary practice location

15929 S Bell Rd
Homer Glen, IL 60491-6707

Mailing address

15929 S Bell Rd
Homer Glen, IL 60491-6707
Phone (708) 745-5600

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131112001030 IL Practitioner - Nurse Practitioner 2163658626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD @ Home Illinois, SCGroup PAC ID 7810167830, 53 clinicians

Practice addresses (Care Compare)

2003 W Fulton St
Suite 303
Chicago, IL 60612-2345
Phone (312) 243-2223

Hospital & facility affiliations

  • Client Home Healthcare, Inc Home health agency, Oak Lawn, IL, CCN 148200

Merit-based Incentive Payment System (MIPS)

Final score
80.62 of 100Reported as group
Quality
64.25
Promoting interoperability
95
Improvement activities
40
Cost
41.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MD @ Home Illinois, SC CurrentSince Nov 27, 2023 Accepting new patients

Locations

2003 W Fulton St
Ste 303
Chicago, IL 60612
Phone (312) 243-2223

Interoperability endpoints

  • Direct secure messaging: denise.wilson.1@3342.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1346674579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15929 S BELL RD",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604916707",
            "telephone_number": "708-745-5600",
            "fax_number": "815-300-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15929 S BELL RD",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604916707",
            "telephone_number": "708-745-5600",
            "fax_number": "815-300-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DENISE",
        "middle_name": "RENA",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "277000402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

Verify at the official NPI Registry.