Active NPI
Amanda Grace Vander Wal, APN
- Family Nurse Practitioner
- Downers Grove, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.009874
- Practice address
- 1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624 - Phone
- (630) 829-1084
- Fax
- (630) 829-1040
- NPI assigned
- Oct 9, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2073 | MN | |
| Family Nurse Practitioner | 363LF0000X | 209.009874 | IL | Primary |
Addresses
Primary practice location
1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Other practice location 1
4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (516) 635-9173
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | avanderwal581588@excellian.direct.allina.com | Other | |
| Direct Messaging Address | avanderwal409652@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1441 Branding Ave
Suite 310
Downers Grove, IL 60515-5624
Phone (630) 829-1084
Hospital & facility affiliations
- Advocate Home Health Care Serv
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.02 of 100
- Quality
- 85.37
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2073 | MN | MD | Acupuncturist |
| 209.009874 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
1441 Branding Ave
Ste 310
Downers Grove, IL 60515
Phone (630) 829-1038
Interoperability endpoints
- avanderwal581588@excellian.direct.allina.com
- avanderwal409652@direct.myadvocateaurora.org
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- General Acute Care Hospital
- Downers Grove, IL
- NPI 1578670543
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Oak Brook, IL
- NPI 1598732075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1811249295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 BRANDING AVE STE 310",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155624",
"telephone_number": "630-829-1084",
"fax_number": "630-829-1040"
}
],
"practiceLocations": [
{
"address_1": "4050 Coon Rapids Blvd NW",
"address_purpose": "LOCATION",
"city": "Coon Rapids",
"state": "MN",
"postal_code": "554332522",
"country_code": "US",
"telephone_number": "516-635-9173",
"fax_number": "651-628-2999",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDER WAL",
"first_name": "AMANDA",
"middle_name": "GRACE",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-09",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "2073",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.009874",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "avanderwal581588@excellian.direct.allina.com",
"affiliation": "N",
"endpointDescription": "Direct",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CDA/PDF/TXT",
"address_1": "4050 Coon Rapids Blvd NW",
"city": "Coon Rapids",
"state": "MN",
"country_code": "US",
"postal_code": "554332522",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "avanderwal409652@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1441 Branding Ave Ste 310",
"city": "Downers Grove",
"state": "IL",
"country_code": "US",
"postal_code": "605155624",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1441 Branding Ave Ste 310",
"city": "Downers Grove",
"state": "IL",
"country_code": "US",
"postal_code": "605155624",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.