Dara Ann Wilczynski, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036148462 Issued in IL

Practice address

2701 17TH St
Rock Island, IL 61201

Phone

(309) 779-2031

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dara Ann Wise Former name

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Midwestern University, Chicago College of Osteopathic Med, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Robert Young Center for Community Mental HealthGroup PAC ID 4587600150, shared by 3 NPIs, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwilczynski685071@direct.unitypoint.org

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.

• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Island, IL
  • NPI 1710276399
  Medicare reassignment NPD
• The Robert Young Center for Community Mental Health

  • Mental Health Counselor
  • Rock Island, IL
  • NPI 1972272516

  IA, Psychiatry

  Medicare reassignment NPD
• Trinity Medical Center

  • Psychiatry Physician
  • Rock Island, IL
  • NPI 1033163829

  IA

  Medicare reassignment NPD
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  Medicare reassignment NPD
• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moline, IL
  • NPI 1912158494

  Psychiatry

  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muscatine, IA
  • NPI 1063224426
  NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1528488897
  NPD (past)

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

• Trinity Medical Center

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1891180154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-779-2031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Utica Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527221626",
            "country_code": "US",
            "telephone_number": "309-779-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCZYNSKI",
        "first_name": "DARA",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "DO-05341",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036148462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARA",
            "last_name": "WISE",
            "middle_name": "ANN",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Penny Jo West
• Joe Lee Westerhof, DVM
• Naomi S Whalen, M.D.
• Alyssa Whitcomb
• White Willow Physical Therapy, PLLC
• Nicholas Allen Wilczynski, D.O.
• Kayla Wilken
• Marissa Leanne Wilkinson, BS, CADC
• Cynthia (Cindy) Dawn Willard, LCP
• Julia Williams

• Psychiatry Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.

Verify at the official NPI Registry.