NPIMap

Organization Active NPI

Western Dupage OB/GYN

  • Medical Physician Assistant
  • Downers Grove, IL
National Provider Identifier
1831475466
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085004210 Issued in IL
Legal business name
WESTERN DUPAGE OB/GYN
Practice address
3800 Highland Ave
Downers Grove, IL 60515-1557
Phone
(630) 810-0777
NPI assigned
Oct 27, 2011
Organization subpart
Yes
Parent organization
WESTERN DUPAGE OB/GYNAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Danielle Marie Everett, PA-CNPI 1225387194
Title
Physician Assistant
Phone
(630) 810-0777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 085004210 IL Primary

Addresses

Primary practice location

3800 Highland Ave
Downers Grove, IL 60515-1557

Mailing address

609 Rebecca LN
Bolingbrook, IL 60440-4859
Phone (630) 392-5025

National Provider Directory

National Provider Directory
Tax ID family
Donahue Furniture18 organizations share this tax ID, including this one
Part of
Donahue Furniture

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1831475466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 REBECCA LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404859",
            "telephone_number": "630-392-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HIGHLAND AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151557",
            "telephone_number": "630-810-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DUPAGE OB/GYN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN DUPAGE OB/GYN",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "630-810-0777",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 27, 2011; 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.