Individual provider Active NPI

Joy M Watson, PA

  • Physician Assistant
  • Gurnee, IL
National Provider Identifier
1083668461
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001638 Issued in IA
Practice address
103 S Greenleaf St Ste J
Gurnee, IL 60031-3380
Phone
(847) 662-8201
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 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 001638 IA Primary

Addresses

Primary practice location

103 S Greenleaf St Ste J
Gurnee, IL 60031-3380

Mailing address

5201 Willow Springs Rd Ste 430
La Grange Highlands, IL 60525-6538
Phone (708) 482-3213

Other names 1

  • Joy M Hendricks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051004000693 IA Practitioner - Physician Assistant 6507891926 Reassigns benefits to 1 organization
I20211008001969 IL Practitioner - Physician Assistant 6507891926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Saint Louis University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Lagrange SCGroup PAC ID 7113830951, 19 clinicians

Practice addresses (Care Compare)

103 S Greenleaf St
Suite J
Gurnee, IL 60031-3380
Phone (847) 662-8201

5201 Willow Springs Rd
Suite 430
La Grange Highlands, IL 60525-6538
Phone (708) 482-3213

Merit-based Incentive Payment System (MIPS)

Final score
83.78 of 100Reported as group
Quality
87.26
Promoting interoperability
100
Improvement activities
40
Cost
58.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Soderstrom Dermatology Center S C CurrentSince Dec 7, 2009 Accepting new patients

Locations

1800 E 54th St
Ste B
Davenport, IA 52807
Phone (563) 242-3571

4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546

Interoperability endpoints

  • Direct secure messaging: jwatson@directaddress.net

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1083668461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD STE 430",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256538",
            "telephone_number": "708-482-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S GREENLEAF ST STE J",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313380",
            "telephone_number": "847-662-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JOY",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOY",
            "last_name": "HENDRICKS",
            "middle_name": "M",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.