Individual provider Active NPI

Jessica Danielle Johnson, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Elk Grove Village, IL
National Provider Identifier
1093071680
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
036.137545 Issued in IL
Practice address
800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367
Phone
(847) 981-3660
Fax
(847) 956-5108
NPI assigned
Apr 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036137545 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036.137545 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367

Mailing address

2160 S 1St Ave
Room 106
Maywood, IL 60153-3328
Phone (708) 216-5402

Other practice location 1

2160 S 1st Ave
Room 106
Maywood, IL 60153-3328
Phone (708) 216-5402

Other practice location 2

4309 W Medical Center Dr Ste B305
McHenry, IL 60050-8418
Phone (847) 802-7400

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sublung@380.direct.myezyaccess.com
Direct Messaging Address jjohnson77418@direct.luhs.org Direct LOYOLA UNIVERSITY MEDICAL CENTER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160825002754 IL Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Hospitalist 1850695537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Loyola University of Chicago, Stritch School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

4309 W Medical Ctr Dr
Suite B305
McHenry, IL 60050-8418
Phone (312) 695-3800

Hospital & facility affiliations

  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.137545ILMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Rush Oak Park Nocturnist CurrentSince Aug 13, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

75 Remittance Dr
Chicago, IL 60675

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2160 S 1st Ave
Rm 106
Maywood, IL 60153
Phone (708) 216-5402

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

4309 W Medical Center Dr
Ste B301
McHenry, IL 60050
Phone (847) 535-6083

4309 W Medical Center Dr
Ste B305
McHenry, IL 60050
Phone (847) 802-7400

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1093071680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "ROOM 106",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5402",
            "fax_number": "708-216-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 510",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073367",
            "telephone_number": "847-981-3660",
            "fax_number": "847-956-5108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_2": "Room 106",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-5402",
            "fax_number": "708-216-6839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4309 W Medical Center Dr Ste B305",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508418",
            "country_code": "US",
            "telephone_number": "847-802-7400",
            "fax_number": "847-802-7399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-08",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036137545",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036.137545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sublung@380.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Rd Ste 510",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson77418@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "address_2": "Room 106",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.