Individual provider Active NPI

Alexandra Rosaria Oetinger, PA-C

  • Surgical Physician Assistant
  • Highland Park, IL
National Provider Identifier
1669337820
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085011984 Issued in IL
Practice address
777 Park Ave W
Highland Park, IL 60035-2433
Phone
(847) 432-8000
NPI assigned
Dec 19, 2025
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085011984 IL Primary

Addresses

Primary practice location

777 Park Ave W
Highland Park, IL 60035-2433

Mailing address

2650 Ridge Ave # 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

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
I20260203002175 IL Practitioner - Physician Assistant 9537647292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

777 Park Ave W
Highland Park, IL 60035-2433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085011984ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 22, 2026 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 22, 2026 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

777 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3744

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1766102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1669337820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE # 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433",
            "telephone_number": "847-432-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OETINGER",
        "first_name": "ALEXANDRA",
        "middle_name": "ROSARIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-19",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085011984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.