Individual provider Active NPI

Rebecca A Patzer, PA-C

  • Physician Assistant
  • Wauconda, IL
National Provider Identifier
1609994425
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002917 Issued in IL
Practice address
431 W Liberty St
Wauconda, IL 60084-2452
Phone
(847) 526-2151
Fax
(847) 526-2017
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 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 085002917 IL Primary

Addresses

Primary practice location

431 W Liberty St
Wauconda, IL 60084-2452

Mailing address

PO Box 6037
Wauconda, IL 60084-6037
Phone (847) 526-2151

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
I20120622000497 IL Practitioner - Physician Assistant 0143485284 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medicine Specialists of Mount Prospect S CGroup PAC ID 8224166566, 16 clinicians
Family Medicine Specialists S.C.Group PAC ID 0042206252, 24 clinicians

Practice addresses (Care Compare)

2253 N Richmond Rd
McHenry, IL 60051-5401
Phone (847) 526-2151

2680 N Il Route 83
Round Lake Beach, IL 60073-4983
Phone (224) 372-7780

425 Lake St
Antioch, IL 60002-1464
Phone (847) 395-2627

431 W Liberty St
Wauconda, IL 60084-2452
Phone (847) 526-2151

604 W Liberty St
Wauconda, IL 60084-3479
Phone (847) 526-2151

909 Belvidere Rd
Waukegan, IL 60085-6313
Phone (847) 244-4995

9700 N Main St
Richmond, IL 60071-7716
Phone (815) 678-4181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085002917ILMDPhysician Assistant

Organizations & group practices 3

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1609994425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6037",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600846037",
            "telephone_number": "847-526-2151",
            "fax_number": "847-526-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W LIBERTY ST",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842452",
            "telephone_number": "847-526-2151",
            "fax_number": "847-526-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATZER",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauconda, IL

Sources for this page

Verify at the official NPI Registry.