Individual provider Active NPI

Kelsie Joann Jamilia Winger, DO

  • Psychiatry Physician
  • Naperville, IL
National Provider Identifier
1962026302
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125.076894 Issued in IL
Practice address
852 S West St
Naperville, IL 60540-6400
Phone
(630) 305-5500
NPI assigned
Jun 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036170739 IL
Psychiatry Physician 2084P0800X 125.076894 IL Primary

Addresses

Primary practice location

852 S West St
Naperville, IL 60540-6400

Mailing address

4901 Searle Pkwy
Skokie, IL 60077-5313

Other practice location 1

350 N Wall St
Kankakee, IL 60901-2991
Phone (815) 933-1671

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821003945 IL Practitioner - Psychiatry 0749728723 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.076894ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 7, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 7, 2024 Accepting new patients
Endeavor Health Clinical Operations PastSince Aug 18, 2024 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

852 S West St
Naperville, IL 60540
Phone (630) 305-5027

Interoperability endpoints

  • Direct secure messaging: kwinger279917@direct.edward.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1962026302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 SEARLE PKWY",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600775313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 S WEST ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406400",
            "telephone_number": "630-305-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Wall St",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609012991",
            "country_code": "US",
            "telephone_number": "815-933-1671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINGER",
        "first_name": "KELSIE",
        "middle_name": "JOANN JAMILIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036170739",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.076894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.