Individual provider Active NPI

Elizah Kathryn Becker, PA-C

  • Physician Assistant
  • Vernon Hills, IL
National Provider Identifier
1396484895
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085010552 Issued in IL
Practice address
870 N Milwaukee Ave
Vernon Hills, IL 60061-1521
Phone
(847) 475-2273
Fax
(847) 535-7761
NPI assigned
Jun 2, 2022
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 085010552 IL Primary

Addresses

Primary practice location

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Mailing address

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521
Phone (847) 475-2273

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
I20240917000824 IL Practitioner - Physician Assistant 0244771343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Northwestern University Feinberg Medical School, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1630 Sherman Ave
Evanston, IL 60201-3711

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 998-9910

350 S Waukegan
Suite 150
Deerfield, IL 60015-5239
Phone (312) 926-3107

350 S Waukegan Rd
Deerfield, IL 60015-5239
Phone (312) 926-6146

6155 Grand Ave
Gurnee, IL 60031-1651

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

7 Blanchard Cir
Wheaton, IL 60189-2038

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 4, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 4, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Pcpa Legacy, LLC PastSince Oct 20, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 4

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": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1396484895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611521",
            "telephone_number": "847-475-2273",
            "fax_number": "847-535-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611521",
            "telephone_number": "847-475-2273",
            "fax_number": "847-535-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "ELIZAH",
        "middle_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

Verify at the official NPI Registry.