Wendy A Frederick, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085002199 Issued in IL

Practice address

904 S Milwaukee Ave Ste B
Libertyville, IL 60048-3215

Phone

(847) 990-7220

Fax

(847) 984-2597

NPI assigned

May 30, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: wendy.frederick@4152.securemail.prognocis.com

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.

• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD (past)
• Midway Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1447397526
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1811198690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 AMELIA CT",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600303373",
            "telephone_number": "847-223-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 S MILWAUKEE AVE STE B",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483215",
            "telephone_number": "847-990-7220",
            "fax_number": "847-984-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "WENDY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steffanie A Francis, PA
• Katharine Lucia Frangos, RN, MSN, CRNA
• Melissa Frank, DPT
• Ludmila Fraszczynski, DDS
• Andrea Freberg, LPC
• Marijo Elizabeth Freedman, O.D.
• Hope Freeland, M.A., CCC-SLP
• Carol Lynn Freeman, PT
• Ronald Lee Freeman, M.D.
• Shayna Friedman

• Physician Assistant in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.