Individual provider Active NPI

Brooke N Johnson, PA-C

  • Physician Assistant
  • St Charles, IL
National Provider Identifier
1205292059
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006560 Issued in IL
Practice address
2900 Foxfield Rd Ste 100
St Charles, IL 60174-5799
Phone
(630) 377-6500
NPI assigned
Jan 10, 2016
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 085.006560 IL Primary
Physician Assistant 363A00000X 10004517A IN

Addresses

Primary practice location

2900 Foxfield Rd Ste 100
St Charles, IL 60174-5799

Mailing address

1104 Northwinds Dr
St Charles, IL 60174-5041
Phone (309) 781-8597

Other practice location 1

301 E Day Rd
Mishawaka, IN 46545-3455
Phone (574) 234-8161

Other practice location 2

3525 Olentangy River Rd
Suite 5320
Columbus, OH 43214-3937
Phone (614) 566-4023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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
I20180726001660 IL Practitioner - Physician Assistant 3375840713 Reassigns benefits to 1 organization
I20260506003642 IN Practitioner - Physician Assistant 3375840713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

301 E Day Rd
Mishawaka, IN 46545-3455
Phone (574) 204-6700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.006560ILMDPhysician Assistant
10004517AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Apr 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Apr 1, 2019 Accepting new patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Central Dupage Hospital Association CurrentSince Aug 1, 2018 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Mount Carmel Health Providers Inc Past Accepting new patients

Locations

2635 Church Rd
Ste 101
Aurora, IL 60502
Phone (630) 315-6900

231 S Gary Ave
Ste 100
Bloomingdale, IL 60108
Phone (630) 893-9600

Dept 5777
Carol Stream, IL 60122

4445 W Irving Park Rd
Ste 110
Chicago, IL 60641
Phone (312) 921-0417

4732 N Lincoln Ave
Chicago, IL 60625
Phone (312) 399-0559

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1001 Commerce Dr
Ste 105
Oak Brook, IL 60523

2900 Foxfield Rd
Ste 100
St Charles, IL 60174
Phone (630) 377-6500

1850 Gateway Dr
Ste 100
Sycamore, IL 60178
Phone (815) 217-3252

7 Blanchard Cir
Ste 102
Wheaton, IL 60189
Phone (630) 510-9009

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

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1452384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1205292059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 NORTHWINDS DR",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745041",
            "telephone_number": "309-781-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD STE 100",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "630-377-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Day Rd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465453455",
            "country_code": "US",
            "telephone_number": "574-234-8161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3525 Olentangy River Rd",
            "address_2": "Suite 5320",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143937",
            "country_code": "US",
            "telephone_number": "614-566-4023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BROOKE",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-10",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006560",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004517A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.