Jessica Weniger, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003264 Issued in IL

Practice address

391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411

Phone

(630) 226-1006

Fax

(630) 226-9003

NPI assigned

Oct 8, 2008

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1679724652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 FOREST HILLS RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611158234",
            "telephone_number": "815-713-2742",
            "fax_number": "815-282-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403411",
            "telephone_number": "630-226-1006",
            "fax_number": "630-226-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENIGER",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PA LICENSE",
            "identifier": "085003264",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Lynn Wegner, LCPC, CADC
• Lauren Len Weigle
• Hilary Wellman, D.C.
• Wellness Made Whole Inc
• Lirlije Wells, RDH
• Gail Maureen West Hooper, LCSW
• West Suburban Eye Center, S.C.
• Susan Wexler, N.P.
• Robin Whatley, MD
• Brenda K. White, LCPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.