NPIMap

Individual provider Active NPI

Bridget Eileen Wiacek, APN

  • Adult Health Nurse Practitioner
  • Wheaton, IL
National Provider Identifier
1871004838
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209.015795 Issued in IL
Practice address
1800 N Main St FL 2
Wheaton, IL 60187-3112
Phone
(630) 315-6123
Fax
(630) 682-3727
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209.015795 IL Primary

Addresses

Primary practice location

1800 N Main St FL 2
Wheaton, IL 60187-3112

Mailing address

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 614-4960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114003539 IL Practitioner - Nurse Practitioner 1355607912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
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)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Hospital & facility affiliations

  • Aim Home Health, Inc Home health agency, Lisle, IL, CCN 148129
  • DMJ Home Health Services, Inc Home health agency, Aurora, IL, CCN 147997
  • Centerwell Home Health II Home health agency, Buffalo Grove, IL, CCN 147979
  • Resilience Home Health, LLC Home health agency, Aurora, IL, CCN 147998
  • Residential Home Health Home health agency, Lisle, IL, CCN 147568
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.015795ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Dec 4, 2017 Accepting new patients
Central Dupage Physician Group CurrentSince Dec 4, 2017 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

636 Raymond Dr
Ste 306
Naperville, IL 60563
Phone (331) 732-4500

1800 N Main St
Fl 2
Wheaton, IL 60187
Phone (630) 315-6123

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

1800 N Main St
Ste 219
Wheaton, IL 60187
Phone (630) 614-4960

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 2

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1871004838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873112",
            "telephone_number": "630-614-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N MAIN ST FL 2",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873112",
            "telephone_number": "630-315-6123",
            "fax_number": "630-682-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIACEK",
        "first_name": "BRIDGET",
        "middle_name": "EILEEN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.015795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.