Individual provider Active NPI

Tracey Ho

  • Physician Assistant
  • Bolingbrook, IL
National Provider Identifier
1043081938
Registry record updated May 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
693 W Boughton Rd
Bolingbrook, IL 60440-1752
Phone
(630) 326-8766
NPI assigned
Jan 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2026

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 Primary

Addresses

Primary practice location

693 W Boughton Rd
Bolingbrook, IL 60440-1752

Mailing address

693 W Boughton Rd
Bolingbrook, IL 60440-1752

Other practice location 1

800 S. Fairmont Ave Ste 412
Pasadena, CA 91105
Phone (626) 898-9797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260501002113 IL Practitioner - Physician Assistant 3072081603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 S Northwest Hwy 200
Park Rldge, IL 60068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Medical Group Corp Past Accepting new patients
Suburban Medical Group Corp PastSince May 12, 2024 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777680000000",
    "number": "1043081938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "693 W BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 W BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401752",
            "telephone_number": "630-326-8766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 S. Fairmont Ave Ste 412",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "91105",
            "country_code": "US",
            "telephone_number": "626-898-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HO",
        "first_name": "TRACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-10",
        "last_updated": "2026-05-02",
        "certification_date": "2026-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.