Jillian Wilder

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17047 La Grange Rd
Orland Park, IL 60487-7227

Phone

(815) 300-7764

NPI assigned

Jul 30, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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.

• Premier Suburban Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Orland Park, IL
  • NPI 1902412950
  Medicare reassignment

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1780413559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17047 LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604877227",
            "telephone_number": "815-300-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17047 LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604877227",
            "telephone_number": "815-300-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy L. Widger, RN
• Fionnuala Wierzgac, REGISTERED NURSE
• Carolyn J Wikstrom, PHARM.D.
• Beth Ann Wilczewski, OTR
• Timothy Wild, COTA
• Ann Wilke, DPT
• William a. Seper, D.D.S., P.C.
• William I Crevier MD LTD
• William Mikaitis MD SC
• Chakika L Williams, APRN

• Physician Assistant in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.