Individual provider Active NPI

Jessica Ruth Wray, PA-C

  • Surgical Physician Assistant
  • Glenview, IL
National Provider Identifier
1720711054
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085010105 Issued in IL
Practice address
2100 Pfingsten Rd.
Glenview, IL 60026-1301
Phone
(847) 503-2710
Fax
(847) 733-5007
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085010105 IL Primary
Physician Assistant 363A00000X 085-010105 IL

Addresses

Primary practice location

2100 Pfingsten Rd.
Glenview, IL 60026-1301

Mailing address

2100 Pfingsten Rd.
Glenview, IL 60026-1301
Phone (847) 503-2710

Other practice location 1

720 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 247-4000

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
I20240206000737 IL Practitioner - Physician Assistant 6406299585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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)

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-010105ILMDPhysician Assistant
085010105ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2025 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

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

2100 Pfingsten Rd
Glenview, IL 60026
Phone (847) 657-5800

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1720711054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD.",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "847-503-2710",
            "fax_number": "847-733-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD.",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "847-503-2710",
            "fax_number": "847-733-5007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Florsheim Dr",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600483757",
            "country_code": "US",
            "telephone_number": "847-247-4000",
            "fax_number": "847-234-2090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRAY",
        "first_name": "JESSICA",
        "middle_name": "RUTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085010105",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-010105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.