Individual provider Active NPI

Brittany Wils, AGPCNP

  • Gerontology Nurse Practitioner
  • Oak Park, IL
National Provider Identifier
1730955816
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209028206 Issued in IL
Practice address
101 Madison St Ste 300
Oak Park, IL 60302-4210
Phone
(708) 486-2700
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 209028206 IL Primary

Addresses

Primary practice location

101 Madison St Ste 300
Oak Park, IL 60302-4210

Mailing address

1801 W Diversey Pkwy Unit 4
Chicago, IL 60614-1041
Phone (224) 567-0530

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
I20240104001863 IL Practitioner - Nurse Practitioner 8426409301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cimpar SCGroup PAC ID 3577578798, 35 clinicians

Practice addresses (Care Compare)

101 Madison St
Suite 300
Oak Park, IL 60302-4210
Phone (708) 486-2700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cimpar, S.C. CurrentSince Dec 20, 2023 Accepting new patients

Locations

101 Madison St
Ste 300
Oak Park, IL 60302
Phone (773) 849-9406

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1730955816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W DIVERSEY PKWY UNIT 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141041",
            "telephone_number": "224-567-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MADISON ST STE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024210",
            "telephone_number": "708-486-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILS",
        "first_name": "BRITTANY",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209028206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.