Individual provider Active NPI

Alexandra Elisabeth Thiel, PA-C, MMSC

  • Physician Assistant
  • Elk Grove Village, IL
National Provider Identifier
1417505983
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1420 Busse Rd
Elk Grove Village, IL 60007-5324
Phone
(847) 653-0142
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1420 Busse Rd
Elk Grove Village, IL 60007-5324

Mailing address

7978 Garfield Ave Apt 205
Burr Ridge, IL 60527-7924

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
I20220309000099 IL Practitioner - Physician Assistant 9133513112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

1420 Busse Rd
Elk Grove Village, IL 60007-5324
Phone (847) 653-0142

1663 Belvidere Rd
Belvidere, IL 61008-9306
Phone (815) 544-0040

1690 W Lake St
Addison, IL 60101-1833
Phone (630) 283-6633

1840 N Richmond Rd
McHenry, IL 60051-5416
Phone (779) 704-3075

2201 Oak Park Ave
Berwyn, IL 60402-2220
Phone (312) 324-0222

226 S Randall Rd
Algonquin, IL 60102-9775
Phone (224) 442-3000

2322 Route 34
Oswego, IL 60543-7132
Phone (630) 383-7042

29 N Northwest Hwy
Palatine, IL 60067-5322
Phone (847) 931-5555

335 E Army Trail Rd
Glendale Heights, IL 60139-1755
Phone (630) 735-1400

405 W Golf Rd
Schaumburg, IL 60195-3501
Phone (224) 215-0011

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

4900 N Cumberland Ave
Norridge, IL 60706-2901
Phone (708) 456-1600

5961 N Lincoln Ave
Chicago, IL 60659-3758
Phone (312) 702-3923

800 W Plainfield Rd
Countryside, IL 60525-3745
Phone (708) 298-0543

8630 W Golf Rd
Niles, IL 60714-5600
Phone (847) 299-0009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1417505983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7978 GARFIELD AVE APT 205",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 BUSSE RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600075324",
            "telephone_number": "847-653-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "ALEXANDRA",
        "middle_name": "ELISABETH",
        "credential": "PA-C, MMSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.