Individual provider Active NPI

Pamela D Piszczek, APRN, FNP-C

  • Nurse Practitioner
  • Willowbrook, IL
National Provider Identifier
1710528740
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.019871 Issued in IL
Practice address
6733 Kingery Hwy
Willowbrook, IL 60527-5142
Phone
(630) 325-4049
Fax
(630) 324-2995
NPI assigned
Oct 1, 2019
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.019871 IL Primary
Family Nurse Practitioner 363LF0000X 209.019871 IL

Addresses

Primary practice location

6733 Kingery Hwy
Willowbrook, IL 60527-5142

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

9551 171st St
Tinley Park, IL 60487-6109
Phone (630) 660-3372

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppiszczek263809@dulyhealthandcare.direct-ci.com Direct

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
I20210203002598 IL Practitioner - Nurse Practitioner 5890109714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

25 N Winfield Rd
Winfield, IL 60190-1222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.019871ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Oct 9, 2023 Accepting new patients
Dupage Medical Group LTD CurrentSince Oct 9, 2023 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

6733 Kingery Hwy
Willowbrook, IL 60527
Phone (630) 325-4049

25 N Winfield Rd
Ste 300
Winfield, IL 60190
Phone (630) 933-8100

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.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1710528740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6733 KINGERY HWY",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275142",
            "telephone_number": "630-325-4049",
            "fax_number": "630-324-2995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9551 171st St",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604876109",
            "country_code": "US",
            "telephone_number": "630-660-3372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PISZCZEK",
        "first_name": "PAMELA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.019871",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.019871",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppiszczek263809@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6733 Kingery Hwy",
            "city": "Willowbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605275142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

Verify at the official NPI Registry.