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NPI 1124902994 · Primary Care Clinic/Center · Lombard, IL
Provider details
- NPI number
- 1124902994
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stephanie Wascher, Advanced Practice Nurse(815) 573-8464
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
716 S Main St
Lombard, IL 60148-3344
Phone: (815) 573-8464
Street-level locationGet directions
Mailing address
1s122 Eliot Ln
Villa Park, IL 60181-3710
Registry dates
- Enumerated
- 2025-08-04
- Last updated
- 2025-08-04
- Certified
- 2025-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.