Mary E Wassilak, WHNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209006774 Issued in IL

Practice address

351 Delnor Dr Ste 204
Geneva, IL 60134-4226

Phone

(630) 208-0784

Fax

(630) 938-9190

NPI assigned

Mar 19, 2009

Last updated

Oct 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Specialty

Nurse Practitioner

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1576

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.

• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment Care Compare group NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Lakeshore Obstetrics and Gynecology LLC

  • Obstetrics Physician
  • Chicago, IL
  • NPI 1588651319
  NPD (past)

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1811138944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 DELNOR DR STE 204",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344226",
            "telephone_number": "630-208-0784",
            "fax_number": "630-938-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 DELNOR DR STE 204",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344226",
            "telephone_number": "630-208-0784",
            "fax_number": "630-938-9190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 N Lake Shore Dr",
            "address_2": "Suite 824",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114546",
            "country_code": "US",
            "telephone_number": "312-943-3300",
            "fax_number": "312-568-4654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSILAK",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006774",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209.006774",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209006774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina M Walters
• Eileen Walts
• Warby Parker Inc.
• Carrie Ward, RN
• James Neal Ward, M.D.
• Gregory Dudley Watson, LCSW,LMFT,ACSW
• Weber Therapy and Consulting, PLLC
• Benjamin Ross Weber, M.D.
• Jacquelyn Suzanne Weber, LCSW
• Christopher Weiss

• Nurse Practitioner in Geneva, IL
• Providers in Geneva, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.