NPIMap

Individual provider Active NPI

Stephan G Wyers, MD

  • Surgery Physician
  • Bolingbrook, IL
National Provider Identifier
1942365788
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036093921 Issued in IL
Practice address
396 Remington Blvd Ste 240
Bolingbrook, IL 60440-4307
Phone
(630) 226-0664
NPI assigned
Dec 22, 2006
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036093921 IL Primary

Addresses

Primary practice location

396 Remington Blvd Ste 240
Bolingbrook, IL 60440-4307

Mailing address

396 Remington Blvd Ste 240
Bolingbrook, IL 60440-4307
Phone (630) 226-0664

Other identifiers 1

IdentifierTypeStateIssuer
036093921MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephan.wyers.1@380.direct.athenahealth.com

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
I20110201000801 IL Practitioner - General Surgery 3072793462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Warren Alpert Medical School of Brown University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health Partners, Inc.Group PAC ID 0244135762, 253 clinicians

Practice addresses (Care Compare)

120 N Oak St
Hinsdale, IL 60521-3829
Phone (630) 856-9000

2363 63Rd St
Woodridge, IL 60517-1369
Phone (630) 716-7510

396 Remington Blvd
Bolingbrook, IL 60440-4311

5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (708) 245-7044

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Apr 25, 2002 Accepting new patients
Adventist Health Partners,Inc CurrentSince Dec 1, 2018 Accepting new patients
The University of Chicago Medical Center CurrentSince Apr 25, 2002 Accepting new patients
Adventist Health Partners, Inc CurrentSince Dec 1, 2018 Accepting new patients
Adventist Health Partners, Inc. Current Accepting new patients
Adventist Health Partners, Inc Surgery Past Accepting new patients
Adventist Health Partners,Inc Past Accepting new patients
Lincoln Surgical Group Surgery Past Accepting new patients

Locations

396 Remington Blvd
Ste 231
Bolingbrook, IL 60440
Phone (630) 312-4301

396 Remington Blvd
Ste 240
Bolingbrook, IL 60440
Phone (630) 226-0664

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Interoperability endpoints

  • Direct secure messaging: stephan.wyers.1@380.direct.athenahealth.com
  • Direct secure messaging: swyers1239828@adventhealth.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1942365788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD STE 240",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404307",
            "telephone_number": "630-226-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD STE 240",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404307",
            "telephone_number": "630-226-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYERS",
        "first_name": "STEPHAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036093921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093921",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephan.wyers.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "396 Remington Blvd Ste 240",
            "city": "Bolingbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604404307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.