Active NPI
Christopher M Northern, PA
- Physician Assistant
- Crystal Lake, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1898-023
- Practice address
- 360 Station Dr
Crystal Lake, IL 60014-7978 - Phone
- (815) 356-2330
- Fax
- (815) 477-9826
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 1898-023 | WI | |
| Physician Assistant | 363A00000X | 1898-023 | WI | Primary |
Addresses
Primary practice location
360 Station Dr
Crystal Lake, IL 60014-7978
Mailing address
360 Station Dr
Crystal Lake, IL 60012
Phone (815) 338-6600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43025400 | Medicaid | WI |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2101 Waukegan Rd
Bannockburn, IL 60015-1836
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.07 of 100
- Quality
- 76.54
- Promoting interoperability
- 83
- Improvement activities
- 40
- Cost
- 74.52
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1898-023 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Bone and Joint Institute, LLC | Current | Accepting new patients | |
| Illinois Bone and Joint Institute LLC | Current | Accepting new patients |
Locations
2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096
5057 Paysphere Cir
Chicago, IL 60674
900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
27401 W State Route 22
Ste 125
Lk Barrington, IL 60010
Phone (847) 381-0388
406 Front St
Ste 100
McHenry, IL 60050
Phone (847) 381-0388
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.
-
- Orthopaedic Surgery Physician
- Bannockburn, IL
- NPI 1205922432
-
- Orthopaedic Surgery Physician
- Arlington Heights, IL
- NPI 1962219568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517529600000",
"number": "1043300767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 STATION DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "60012",
"telephone_number": "815-338-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 STATION DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147978",
"telephone_number": "815-356-2330",
"fax_number": "815-477-9826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHERN",
"first_name": "CHRISTOPHER",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2018-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "1898-023",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "1898-023",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43025400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Crystal Lake, IL
- Northern Illinois Medical Center
- Northern Illinois Plastic Surgery
- Northern Illinois Recovery LLC
- Northern Illinois Recovery LLC
- Northern Illinois Recovery LLC
- Northland Hearing Centers, Inc.
- Northwest Autism Diagnostic Center, LLC
- Northwest Pain Management Center LTD
- Northwest Suburban Surgical Services
- Megan Norton, LMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.