Individual provider Active NPI

Jacob James Luka, PA-C

  • Physician Assistant
  • Rolling Meadows, IL
National Provider Identifier
1083479414
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1669 Algonquin Rd
Rolling Meadows, IL 60008-4290
Phone
(847) 310-3211
NPI assigned
Feb 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

1669 Algonquin Rd
Rolling Meadows, IL 60008-4290

Mailing address

7762 Dada Dr
Gurnee, IL 60031-5178
Phone (847) 596-1479

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
I20240422002228 IL Practitioner - Physician Assistant 9032558168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

5228 N Northwest Hwy
Chicago, IL 60630-4620
Phone (773) 770-4707

6140 N Broadway St
Chicago, IL 60660-2538
Phone (773) 435-9028

6831 N Ave
Oak Park, IL 60302-1023
Phone (847) 653-0130

811 S State St
Chicago, IL 60605-2225
Phone (312) 566-9510

825 S State St
Chicago, IL 60605-2225
Phone (312) 566-9510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1083479414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7762 DADA DR",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315178",
            "telephone_number": "847-596-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 ALGONQUIN RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600084290",
            "telephone_number": "847-310-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKA",
        "first_name": "JACOB",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-07-03",
        "certification_date": "2024-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Meadows, IL

Sources for this page

Verify at the official NPI Registry.