Jennifer Phillips, RSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

238000670 Issued in IL

Practice address

6330 Belmont Rd Ste 5
Downers Grove, IL 60516-2126

Phone

(713) 779-9800

Fax

(713) 779-9862

NPI assigned

Nov 18, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Priority Assist PLLC

  • Surgical Physician Assistant
  • Plano, IL
  • NPI 1477169522
  NPD Authorized official
• Chicagoland Surgical Assistants Inc.

  • Specialist
  • Downers Grove, IL
  • NPI 1750919155
  NPD

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1053957746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7324 SOUTHWEST FWY STE 1550",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742053",
            "telephone_number": "713-779-9800",
            "fax_number": "713-779-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 BELMONT RD STE 5",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605162126",
            "telephone_number": "713-779-9800",
            "fax_number": "713-779-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JENNIFER",
        "credential": "RSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238000670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Helen Peterson, MS, OTR/L
• Robert Kenneth Peterson, D.M.D.
• Walter Petri, M.D.
• Marissa N Pezzulo, LCSW
• Carrie Phillips
• Valerie Phillips, MD
• Sophia Phoenix
• Physician on Wheels
• Physicians Revenue Group
• Natalia Maria Pierwola, M.S. CF-SLP

• Surgical Physician Assistant in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.