Individual provider Active NPI

Allison J. Manley, PA-C

  • Physician Assistant
  • Palos Heights, IL
National Provider Identifier
1497305221
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008770 Issued in IL
Practice address
7530 W College Dr Ste D
Palos Heights, IL 60463-1197
Phone
(708) 671-1374
NPI assigned
Sep 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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 085008770 IL Primary

Addresses

Primary practice location

7530 W College Dr Ste D
Palos Heights, IL 60463-1197

Mailing address

7530 W College Dr Ste D
Palos Heights, IL 60463-1197
Phone (708) 671-1374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191029001331 NC Practitioner - Physician Assistant 3577895309
I20220208001262 IL Practitioner - Physician Assistant 3577895309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Dermatology Institute, LLCGroup PAC ID 7911043054, 51 clinicians

Practice addresses (Care Compare)

1550 N Northwest Hwy
Suite 300
Park Ridge, IL 60068-1475
Phone (847) 298-1831

9711 Skokie Blvd
Suite J
Skokie, IL 60077-1384
Phone (847) 675-9711

Hospital & facility affiliations

  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085008770ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Dermpath Laboratory Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amanley@illinois.emadirect.md

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.

Hospital & facility affiliations 2

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": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1497305221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 W COLLEGE DR STE D",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631197",
            "telephone_number": "708-671-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 W COLLEGE DR STE D",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631197",
            "telephone_number": "708-671-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "ALLISON",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.