Individual provider Active NPI

Maureen Penn

  • Family Medicine Physician
  • Geneva, IL
National Provider Identifier
1437899119
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125080186 Issued in IL
Practice address
298 Randall Rd
Geneva, IL 60134-4203
Phone
(630) 208-3000
NPI assigned
Mar 30, 2022
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125080186 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

298 Randall Rd
Geneva, IL 60134-4203

Mailing address

298 Randall Rd
Geneva, IL 60134-4203
Phone (630) 208-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Apr 3, 2022 Accepting new patients
Central Dupage Physician Group PastSince Apr 3, 2022 Accepting new patients

Locations

298 Randall Rd
Geneva, IL 60134
Phone (630) 938-3300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1437899119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344203",
            "telephone_number": "630-208-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344203",
            "telephone_number": "630-208-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "MAUREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125080186",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.