Eden Ann Llewellyn, MMS PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004926 Issued in IL

Practice address

852 S West St
Naperville, IL 60540-6400

Phone

(630) 305-5500

NPI assigned

Nov 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Eden Ann Steege Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1384041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1588093553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HIGHPOINT DR",
            "address_2": "APT 204",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604463830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 S WEST ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406400",
            "telephone_number": "630-305-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLEWELLYN",
        "first_name": "EDEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MMS PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-10",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDEN",
            "last_name": "STEEGE",
            "middle_name": "ANN",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physician Assistant in Naperville, IL
• Providers in Naperville, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.