Individual provider Active NPI

Jessica Berger, PA-C

  • Physician Assistant
  • Evergreen Park, IL
National Provider Identifier
1134639008
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006381 Issued in IL
Practice address
9760 S Kedzie Ave Ste 3
Evergreen Park, IL 60805-3184
Phone
(708) 423-6209
NPI assigned
Oct 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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 085006381 IL Primary

Addresses

Primary practice location

9760 S Kedzie Ave Ste 3
Evergreen Park, IL 60805-3184

Mailing address

9760 S Kedzie Ave
Evergreen Park, IL 60805-3109
Phone (708) 423-6209

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
I20191029001377 IL Practitioner - Physician Assistant 1658603485 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085006381ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Headache Lab CurrentSince Sep 25, 2019 Accepting new patients

Locations

9760 S Kedzie Ave
Ste 3
Evergreen Pk, IL 60805
Phone (708) 423-6209

9760 S Kedzie Ave
Evergreen Pk, IL 60805
Phone (708) 423-2660

9760 S Kedzie Ave
Ste 2
Evergreen Pk, IL 60805
Phone (708) 423-8150

Interoperability endpoints

  • Direct secure messaging: jessica.schafer.1@27901.direct.athenahealth.com

Organizations & group practices 3

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": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1134639008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053109",
            "telephone_number": "708-423-6209",
            "fax_number": "708-423-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE STE 3",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053184",
            "telephone_number": "708-423-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-05",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.