Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Grace-Marie Martina Ottomanelli, PA-C

Individual provider Physician Assistant · NPI 1457756272

Grace-Marie Martina Ottomanelli, PA-C is a Physician Assistant in Geneva, Illinois. Qualified in 2014, 12 years ago. Practices with Central Dupage Physician Group, a 1,094-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Licensed in
IL
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2425 Fargo Blvd
Geneva, IL 60134-3591
Phone: (630) 232-2200
Fax: (630) 232-1940
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 905 N 1st St Ste A, Elburn, IL 60119-9150 — (630) 232-2200
  • 153 1/2 North 19th Avenue, Melrose Park, IL 60160-3702 — (708) 345-8960

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.005311 (IL)

Record details

NPI number1457756272
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 23, 2014
Last updated in NPPESJanuary 16, 2023
Certification dateJanuary 16, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Central Dupage Physician Group — 1094 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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