Active NPI
Rhonda Wiley, IDC
- Independent Duty Corpsman
- Great Lakes, IL
National Provider Identifier
1447564232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 2410 Sampson St
Great Lakes, IL 60088-2942 - Phone
- (847) 688-2092
- NPI assigned
- Aug 4, 2010
- Last updated
- Aug 4, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | NU | Primary |
Addresses
Primary practice location
2410 Sampson St
Great Lakes, IL 60088-2942
Mailing address
1710 Kayla LN
Apt 2B
Waukegan, IL 60087-5056
Phone (757) 286-0777
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1447564232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 KAYLA LN",
"address_2": "APT 2B",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600875056",
"telephone_number": "757-286-0777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 SAMPSON ST",
"city": "GREAT LAKES",
"state": "IL",
"postal_code": "600882942",
"telephone_number": "847-688-2092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "RHONDA",
"credential": "IDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-04",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Lakes, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.