Individual provider Active NPI

Jacob Padraig Reilley Luther, MD

  • Family Medicine Physician
  • Kildeer, IL
National Provider Identifier
1285210773
Registry record updated May 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036170914 Issued in IL
Practice address
21481 N Rand Rd FL 2
Kildeer, IL 60047-3061
Phone
(847) 618-0217
Fax
(847) 618-0676
NPI assigned
Mar 23, 2021
Last updated
May 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 036170914 IL
Family Medicine Physician 207Q00000X 036170914 IL Primary

Addresses

Primary practice location

21481 N Rand Rd FL 2
Kildeer, IL 60047-3061

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone (847) 318-2710

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630001276 IL Practitioner - Family Practice 9133500838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

21481 N Rand Rd
Kildeer, IL 60047-3061
Phone (847) 618-9696

2650 Ridge Ave
Evanston, IL 60201-1700

3060 W Salt Creek LN
Arlington Heights, IL 60005-1069

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036170914ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jun 1, 2025 Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Jun 1, 2025 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

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

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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

21481 N Rand Rd
Kildeer, IL 60047
Phone (847) 618-9696

21481 N Rand Rd
Fl 2
Kildeer, IL 60047
Phone (847) 221-4900

21481 N Rand Rd
Fl Second
Kildeer, IL 60047

1775 Ballard Rd
Park Ridge, IL 60068
Phone (847) 318-6020

Interoperability endpoints

  • Direct secure messaging: jluther171249@uihealth.direct-ci.com
  • Direct secure messaging: jluther206048@direct.nch.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1285210773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040",
            "fax_number": "847-570-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21481 N RAND RD FL 2",
            "city": "KILDEER",
            "state": "IL",
            "postal_code": "600473061",
            "telephone_number": "847-618-0217",
            "fax_number": "847-618-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Ballard Rd",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681005",
            "country_code": "US",
            "telephone_number": "847-318-2710",
            "fax_number": "847-318-2917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "JACOB",
        "middle_name": "PADRAIG REILLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036170914",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036170914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kildeer, IL

Sources for this page

Verify at the official NPI Registry.