Individual provider Active NPI

Colby Paul Wiley, PHD

  • Clinical Neuropsychologist
  • Geneva, IL
National Provider Identifier
1366079907
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071010334 Issued in IL
Practice address
302 Randall Rd Ste 308
Geneva, IL 60134-4205
Phone
(630) 524-5845
Fax
(630) 208-3007
NPI assigned
Mar 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 071010334 IL Primary

Addresses

Primary practice location

302 Randall Rd Ste 308
Geneva, IL 60134-4205

Mailing address

302 Randall Rd Ste 308
Geneva, IL 60134-4205
Phone (630) 524-5845

Other practice location 1

25 N Winfield Rd Ste 432
Winfield, IL 60190-1379
Phone (630) 933-4056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 9, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 9, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

302 Randall Rd
Ste 308
Geneva, IL 60134
Phone (630) 208-7388

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

0N025 Winfield Rd
Winfield, IL 60190
Phone (630) 832-0050

25 N Winfield Rd
Ste 432
Winfield, IL 60190

Organizations & group practices 2

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1366079907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD STE 308",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344205",
            "telephone_number": "630-524-5845",
            "fax_number": "630-208-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD STE 308",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344205",
            "telephone_number": "630-524-5845",
            "fax_number": "630-208-3007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 N Winfield Rd Ste 432",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "IL",
            "postal_code": "601901379",
            "country_code": "US",
            "telephone_number": "630-933-4056",
            "fax_number": "630-933-5868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "COLBY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071010334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.