Individual provider Active NPI

Amanda B. Wendel, M.D.

  • Dermatology Physician
  • St Charles, IL
National Provider Identifier
1699973131
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036127582 Issued in IL
Practice address
2900 Foxfield Rd Ste 101
St Charles, IL 60174-5799
Phone
(630) 315-6500
Fax
(630) 315-6519
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036127582 IL Primary

Addresses

Primary practice location

2900 Foxfield Rd Ste 101
St Charles, IL 60174-5799

Mailing address

5N134 Prairie Rose Dr
St Charles, IL 60175-7943
Phone (217) 816-9254

Other identifiers 1

IdentifierTypeStateIssuer
906720OtherILMEDICARE PTAN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110705000373 IL Practitioner - Dermatology 9638203474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Southern Illinois University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

2900 Foxfield Rd
St Charles, IL 60174-5799

636 Raymond Dr
Suite 204
Naperville, IL 60563-9791
Phone (630) 682-8700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision23
Removal of skin lesions547
Removal or shaving of skin growth62
Skin biopsy108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036127582ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 16, 2019 Accepting new patients
Dermatology Clinic of Iowa PC CurrentSince Aug 1, 2010 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 16, 2019 Accepting new patients
Des Plaines Dermatology, LTD. Dermatology Past Accepting new patients

Locations

1815 1st Ave SE
Ste 200
Cedar Rapids, IA 52402
Phone (319) 363-0474

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

2900 Foxfield Rd
Ste 101
St Charles, IL 60174
Phone (630) 513-8275

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

Organizations & group practices 4

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 2

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1699973131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5N134 PRAIRIE ROSE DR",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601757943",
            "telephone_number": "217-816-9254",
            "fax_number": "319-339-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD STE 101",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "630-315-6500",
            "fax_number": "630-315-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDEL",
        "first_name": "AMANDA",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036127582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "906720",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.