MRS. JENNIFER LEE WETTELAND (NPI# 1396804282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396804282 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER LEE WETTELAND |
| Credential | PA-C |
| Practice Address |
4805 Prime Pkwy Mchenry IL 60050-7002 |
| Practice Telephone | 8153639500 |
| Practice Fax Number | 8153639696 |
| Mailing Telephone | 8153639500 |
| Mailing Fax Number | 8153639696 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4805 PRIME PKWY |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-7002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548267479 | Phyllis Ruth Dalla Betta | Nurse Practitioner | 4805 Prime Pkwy, Mchenry, IL 60050-7002 | 2005-07-07 |
| 1194270926 | Gypsum Medical Associates of California PC | Family Medicine | 4805 Prime Pkwy, Mchenry, IL 60050-7002 | 2016-08-22 |
| 1225122344 | Medcor of Barrington, PC | Family Medicine | 4805 Prime Pkwy, Mchenry, IL 60050-7002 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710973458 | John A. Sharum | Physician Assistant | 4201 W Medical Center Dr, Emergency Department, Mchenry, IL 60050-8409 | 2005-09-27 |
| 1982152781 | Nicole Villanueva | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2016-09-21 |
| 1942632567 | Deborah L Bailey | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050 | 2013-08-06 |
| 1922444835 | Benjamin Jeffery Foerster | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2013-05-18 |
| 1053678557 | Nilam M Patel | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050 | 2012-04-20 |
| 1942300033 | Amy Elizabeth Underwood | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2006-09-25 |
| 1538172739 | Kimberly D Ackert | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050 | 2006-08-15 |
| 1871606079 | Scott Colburn | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2006-08-15 |
| 1770696890 | Stacie L Johnson | Physician Assistant | 4309 W Medical Center Dr, Mchenry, IL 60050-8419 | 2006-08-15 |
| 1215970249 | Illinois/indiana Em-i Medical Services, S.c. | Physician Assistant | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2006-06-14 |
| Find all providers in MCHENRY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.