Individual provider Active NPI

Colleen Mary Webb, PA-C

  • Physician Assistant
  • Maywood, IL
National Provider Identifier
1962983999
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006650 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Aug 27, 2018
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.006650 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

353 N Desplaines St Apt 2104
Chicago, IL 60661-1352
Phone (630) 742-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA, GA, WI, NY5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20180920002527 IL Practitioner - Physician Assistant 8325399934 Reassigns benefits to 1 organization
I20220228000356 IA Practitioner - Physician Assistant 8325399934 Reassigns benefits to 2 organizations
I20220712000437 GA Practitioner - Physician Assistant 8325399934 Reassigns benefits to 1 organization
I20231208002010 WI Practitioner - Physician Assistant 8325399934 Reassigns benefits to 1 organization
I20250904000205 NY Practitioner - Physician Assistant 8325399934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.006650ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Surgery Associates SC CurrentSince Dec 1, 2022 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jun 22, 2022 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 29, 2023 Accepting new patients
Genesis Health System CurrentSince Sep 1, 2024 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 29, 2023 Accepting new patients
North Medical PC Current Accepting new patients
Emory Medical Care Foundation CurrentSince Jun 22, 2022 Accepting new patients

Locations

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

4480 Utica Ridge Rd
Ste 2222
Bettendorf, IA 52722
Phone (563) 742-3111

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

880 W Central Rd
Ste 7100
Arlington Hts, IL 60005
Phone (847) 392-7810

2900 N Lake Shore Dr
Ste 904
Chicago, IL 60657

3000 N Halsted St
Ste 606
Chicago, IL 60657
Phone (773) 296-3700

7447 W Talcott Ave
Ste 512
Chicago, IL 60631
Phone (773) 237-8722

2650 Warrenville Rd
Ste 280
Downers Grove, IL 60515
Phone (630) 324-7920

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

133 E Brush Hill Rd
Ste 200
Elmhurst, IL 60126

800 Austin St
Ste 557
Evanston, IL 60202
Phone (847) 316-4455

301 Madison St
Ste 280
Joliet, IL 60435
Phone (630) 324-7915

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

500 John Deere Rd
Moline, IL 61265
Phone (309) 779-2840

801 S Washington St
Fl 4
Naperville, IL 60540
Phone (630) 416-8500

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

1875 W Dempster St
Ste 410
Park Ridge, IL 60068
Phone (847) 318-9595

2560 24th St
Ste 201
Rock Island, IL 61201
Phone (309) 779-3111

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

Organizations & group practices 10

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 1

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": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1962983999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 N DESPLAINES ST APT 2104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611352",
            "telephone_number": "630-742-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.