Individual provider Active NPI

Stacy Schilz, PA

  • Physician Assistant
  • Gurnee, IL
National Provider Identifier
1982835740
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003515 Issued in IL
Practice address
350 S Greenleaf St Ste 405
Gurnee, IL 60031-5709
Phone
(847) 336-3335
Fax
(847) 336-3249
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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 085-003515 IL Primary

Addresses

Primary practice location

350 S Greenleaf St Ste 405
Gurnee, IL 60031-5709

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Other names 1

  • Stacy Schmitz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20090831000489 IL Practitioner - Physician Assistant 6204981012 Reassigns benefits to 1 organization
I20240329002485 WI Practitioner - Physician Assistant 6204981012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ganesha Institute of Neurology and Psychiatry SCGroup PAC ID 0042432296, 25 clinicians

Practice addresses (Care Compare)

1860 W Winchester Rd
Suite 106
Libertyville, IL 60048-5312
Phone (847) 816-6335

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-003515ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ganesha Institute of Neurology and Psychiatry SC Physician Assistant CurrentSince Feb 28, 2024 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Physician Assistant CurrentSince Mar 1, 2024 Accepting new patients

Locations

1850 W Winchester Rd
Ste 115
Libertyville, IL 60048
Phone (847) 816-6335

1860 W Winchester Rd
Ste 106
Libertyville, IL 60048
Phone (847) 599-0715

4600 Green Bay Rd
Kenosha, WI 53144
Phone (847) 816-6335

Interoperability endpoints

  • Direct secure messaging: stacy.schilz.1@9664.direct.athenahealth.com

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 6

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1982835740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S GREENLEAF ST STE 405",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315709",
            "telephone_number": "847-336-3335",
            "fax_number": "847-336-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILZ",
        "first_name": "STACY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "SCHMITZ",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.