Individual provider Active NPI

Elizabeth M Showalter, NP

  • Nurse Practitioner
  • Glen Ellyn, IL
National Provider Identifier
1780050062
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-016949 Issued in IL
Practice address
430 Pennsylvania Ave Ste 350
Glen Ellyn, IL 60137-4464
Phone
(630) 790-1700
NPI assigned
Aug 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 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 209-016949 IL Primary
Nurse Practitioner 363L00000X 6574 WI

Addresses

Primary practice location

430 Pennsylvania Ave Ste 350
Glen Ellyn, IL 60137-4464

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address eshowalter175377@direct.edward.org
Direct Messaging Address eshowalter175377@dulyhealthandcare.direct-ci.com

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
I20180219001958 IL Practitioner - Nurse Practitioner 6709193253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-016949ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Mar 5, 2018 Accepting new patients
Dupage Medical Group LTD CurrentSince Mar 5, 2018 Accepting new patients

Locations

220 Springfield Dr
Ste 320
Bloomingdale, IL 60108

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

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

430 Pennsylvania Ave
Glen Ellyn, IL 60137
Phone (630) 545-7576

430 Pennsylvania Ave
Ste 350
Glen Ellyn, IL 60137
Phone (630) 545-7660

430 Warrenville Rd
Ste 310PT
Lisle, IL 60532

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

Interoperability endpoints

  • Direct secure messaging: eshowalter7323@aurora.direct-ci.com
  • Direct secure messaging: eshowalter175377@direct.edward.org

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 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": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1780050062",
    "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": "430 PENNSYLVANIA AVE STE 350",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374464",
            "telephone_number": "630-790-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-016949",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eshowalter175377@direct.edward.org",
            "affiliation": "N",
            "address_1": "430 Pennsylvania Ave Ste 350",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601374464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eshowalter175377@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "430 Pennsylvania Ave Ste 350",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601374464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

Verify at the official NPI Registry.