Judith A Wakeland, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001026 Issued in IL

Practice address

1000 W Harlem Ave
Monmouth, IL 61462-1099

Phone

(309) 734-3141

Fax

(309) 734-3029

NPI assigned

Jan 30, 2006

Last updated

Jul 29, 2014By 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 2

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

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1831160779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621099",
            "telephone_number": "309-734-3141",
            "fax_number": "309-734-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621099",
            "telephone_number": "309-734-3141",
            "fax_number": "309-734-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKELAND",
        "first_name": "JUDITH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041127252",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Lynn Thornton, APN
• Amy S Toal, LMT
• John Turnquist
• Vitala Health Group LLC
• Kurt E Volz, LCSW, CADC
• Walgreen Co (Walgreens #11881)
• Walgreen Co. (Walgreens #11881)
• Warren Achievement Center
• Warren Achievement Center Inc
• John Henry Wegmann, DC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.