Individual provider Active NPI

Tamika Latoya Hobson, PA-C

  • Physician Assistant
  • Cicero, IL
National Provider Identifier
1174670368
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-002730 Issued in IL
Practice address
5909 W 35TH St
Cicero, IL 60804-4163
Phone
(708) 652-2040
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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 085-002730 IL Primary

Addresses

Primary practice location

5909 W 35TH St
Cicero, IL 60804-4163

Mailing address

1224 N Humphrey Ave
Oak Park, IL 60302-1112

Other practice location 1

1901 W Galena Blvd
Aurora, IL 60506-4305
Phone (630) 692-5960

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
I20070504000068 IL Practitioner - Physician Assistant 5092811273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-002730ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush-Copley Medical Group, NFP CurrentSince Jul 1, 2023 Accepting new patients

Locations

1901 W Galena Blvd
Aurora, IL 60506
Phone (630) 692-5960

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1174670368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 N HUMPHREY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 W 35TH ST",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608044163",
            "telephone_number": "708-652-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 W Galena Blvd",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605064305",
            "country_code": "US",
            "telephone_number": "630-692-5960",
            "fax_number": "630-692-5961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOBSON",
        "first_name": "TAMIKA",
        "middle_name": "LATOYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

Verify at the official NPI Registry.