Individual provider Active NPI

Mary Ahn, MD

  • Surgery Physician
  • Winfield, IL
National Provider Identifier
1407809056
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036-096682 Issued in IL
Practice address
25 N Winfield Rd Ste 2202
Winfield, IL 60190-1379
Phone
(630) 307-7799
Fax
(630) 307-2277
NPI assigned
May 17, 2006
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036-096682 IL Primary

Addresses

Primary practice location

25 N Winfield Rd Ste 2202
Winfield, IL 60190-1379

Mailing address

25 N Winfield Rd Ste 2202
Winfield, IL 60190-1379
Phone (630) 307-7799

Other practice location 1

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799

Other practice location 2

4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 307-7799

Other identifiers 3

IdentifierTypeStateIssuer
036096682MedicaidIL
206147228OtherILMEDICARE PTAN (INDIVIDUAL)
206147OtherILMEDICARE PTAN (GROUP)

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
I20070416000581 IL Practitioner - General Surgery 2961472246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

25 N Winfield Rd
Winfield, IL 60190-1379
Phone (630) 352-5450

444 N Park Blvd
Glen Ellyn, IL 60137-4622
Phone (630) 469-0045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy66
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-096682ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jan 28, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Central Dupage Physician Group CurrentSince Jan 28, 2013 Accepting new patients
West Suburban Surgical Associates, LTD. Surgery Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

473 W Army Trail Rd
Ste 107
Bloomingdale, IL 60108
Phone (224) 520-8562

Dept 5777
Carol Stream, IL 60122

304 Randall Rd
Geneva, IL 60134
Phone (630) 232-0610

351 Delnor Dr
Geneva, IL 60134
Phone (630) 262-1001

444 N Park Blvd
Glen Ellyn, IL 60137
Phone (630) 469-0045

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4405 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 352-5450

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

25 N Winfield Rd
Ste 2202
Winfield, IL 60190
Phone (630) 352-5450

25 N Winfield Rd
Ste 410
Winfield, IL 60190
Phone (630) 665-2101

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1407809056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD STE 2202",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD STE 2202",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344200",
            "country_code": "US",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4405 Weaver Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warrenville",
            "state": "IL",
            "postal_code": "605553269",
            "country_code": "US",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-096682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096682",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147228",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.