NPIMap

Individual provider Active NPI

Jay Anthony Liboon, D.O.

  • Hospitalist Physician
  • Oak Park, IL
National Provider Identifier
1265669436
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036129008 Issued in IL
Practice address
520 S Maple Ave
Oak Park, IL 60304
Phone
(630) 842-6677
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125056587 IL
Hospitalist Physician 208M00000X 036129008 IL Primary

Addresses

Primary practice location

520 S Maple Ave
Oak Park, IL 60304

Mailing address

520 S Maple Ave
Oak Park, IL 60304-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120727000793 IL Practitioner - HospitalistPractitioner - Internal Medicine 1557527066 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians
Rush Oak Park Physicians Group Adult MedicineGroup PAC ID 3476716523, 17 clinicians

Practice addresses (Care Compare)

520 S Maple Ave
Oak Park, IL 60304-1022
Phone (708) 660-2240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125056587ILMDInternal Medicine Physician
036129008ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 1, 2012 Accepting new patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
Rush Oak Park Physicians Group Adult Medicine Internal Medicine CurrentSince Jan 1, 2017 Accepting new patients
Rush University Medical Group Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Rush University Medical Center CurrentSince Aug 1, 2025 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

9532 Eagle Way
Chicago, IL 60678

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Chicago, IL 60675

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

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

610 S Maple Ave
Ste 4600
Oak Park, IL 60304
Phone (708) 660-2240

Interoperability endpoints

  • Direct secure messaging: jliboon130223@direct.rush.rush-health.com

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": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1265669436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S MAPLE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S MAPLE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60304",
            "telephone_number": "630-842-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBOON",
        "first_name": "JAY",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125056587",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036129008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.