Individual provider Active NPI

Emily Weiss, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1417619958
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.010769 Issued in IL
Practice address
1931 N Halsted St
Chicago, IL 60614-5008
Phone
(312) 219-2230
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 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 085.010769 IL Primary

Addresses

Primary practice location

1931 N Halsted St
Chicago, IL 60614-5008

Mailing address

1931 N Halsted St
Chicago, IL 60614-5008
Phone (312) 219-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 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
I20211014001603 MI Practitioner - Physician Assistant 5597163907 Reassigns benefits to 6 organizations
I20250110000775 IL Practitioner - Physician Assistant 5597163907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

1931 N Halsted St
Chicago, IL 60614-5008
Phone (888) 663-6331

730 Waukegan Rd
Deerfield, IL 60015-4304
Phone (888) 663-6331

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.010769ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. CurrentSince Feb 1, 2025 Accepting new patients
One Medical Group, Inc CurrentSince Feb 1, 2025 Accepting new patients
Harper Woods Urgent Care and Medical Center PLLC PastSince Jul 7, 2019 Accepting new patients
Rush Oak Park Physicians Group Lake Street Past Accepting new patients
Henry Ford Macomb Hospital Corporation Past Accepting new patients

Locations

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

1931 N Halsted St
Chicago, IL 60614
Phone (312) 998-5510

730 Waukegan Rd
Deerfield, IL 60015

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1417619958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145008",
            "telephone_number": "312-219-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145008",
            "telephone_number": "312-219-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.