Individual provider Active NPI

Deborah L. Wenninger, PA

  • Physician Assistant
  • Naperville, IL
National Provider Identifier
1508852245
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001702 Issued in IL
Practice address
1259 Rickert Dr
Suite 101
Naperville, IL 60540-8902
Phone
(630) 968-1881
Fax
(630) 968-3762
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085001702 IL
Physician Assistant 363A00000X 085001702 IL Primary

Addresses

Primary practice location

1259 Rickert Dr
Suite 101
Naperville, IL 60540-8902

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 2

IdentifierTypeStateIssuer
P000324870OtherILRAILROAD MEDICARE
085001702MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwenninger26577@dulyhealthandcare.direct-ci.com

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
I20041005000070 IL Practitioner - Physician Assistant 4486613692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

100 Spalding Dr
Suite 3
Naperville, IL 60540-6550
Phone (630) 355-8000

1800 N Main St
Wheaton, IL 60187-3149
Phone (630) 665-6200

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jul 1, 2013 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 1, 2013 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Ste 230
Chicago, IL 60674

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

4115 Fairview Ave
Downers Grove, IL 60515
Phone (630) 968-1881

3825 Highland Ave
Ste 5H
Downers Grove, IL 60515
Phone (630) 275-9060

908 N Elm St
Ste 310
Hinsdale, IL 60521
Phone (630) 325-3310

1259 Rickert Dr
Ste 101
Naperville, IL 60540
Phone (630) 355-1300

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

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 1

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1508852245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200",
            "fax_number": "630-245-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 RICKERT DR",
            "address_2": "SUITE 101",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408902",
            "telephone_number": "630-968-1881",
            "fax_number": "630-968-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNINGER",
        "first_name": "DEBORAH",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085001702",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P000324870",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085001702",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwenninger26577@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1259 Rickert Dr",
            "address_2": "Suite 101",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605408902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.