Individual provider Active NPI

Andrew Montoya

  • Physician Assistant
  • Cicero, IL
National Provider Identifier
1205784014
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.012161 Issued in IL
Practice address
5741 W Cermak Rd
Cicero, IL 60804-2129
Phone
(708) 222-0100
NPI assigned
Mar 18, 2026
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 085.012161 IL Primary

Addresses

Primary practice location

5741 W Cermak Rd
Cicero, IL 60804-2129

Mailing address

146 N Myrtle Ave
Villa Park, IL 60181-2225
Phone (630) 484-3696

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
I20260521002770 IL Practitioner - Physician Assistant 2163992975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cermak Medical Group LLCGroup PAC ID 7113269242, 21 clinicians

Practice addresses (Care Compare)

5741 W Cermak Rd
Cicero, IL 60804-2129
Phone (708) 222-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.012161ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cermak Medical Group LLC CurrentSince Apr 14, 2026 Accepting new patients

Locations

5741 W Cermak Rd
Cicero, IL 60804
Phone (708) 222-0100

1669 Algonquin Rd
Rolling Meadows, IL 60008
Phone (847) 310-3211

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1205784014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 N MYRTLE AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812225",
            "telephone_number": "630-484-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5741 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042129",
            "telephone_number": "708-222-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.012161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

Verify at the official NPI Registry.