NPIMap

Individual provider Active NPI

Jimmy Chagoya

  • Physician Assistant
  • Libertyville, IL
National Provider Identifier
1417639337
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-009892 Issued in IL
Practice address
720 Florsheim Dr
Libertyville, IL 60048-3757
Phone
(847) 247-4000
Fax
(847) 234-2090
NPI assigned
Aug 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 085-009892 IL Primary

Addresses

Primary practice location

720 Florsheim Dr
Libertyville, IL 60048-3757

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

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
I20230907003711 IL Practitioner - Physician Assistant 9537523659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Pain Treatment Institute LTDGroup PAC ID 3577464940, 10 clinicians

Practice addresses (Care Compare)

22285 N Pepper Rd
Suite 302
Lake Barrington, IL 60010-2541
Phone (847) 852-2000

4309 W Medical Ctr Dr
Suite B103
McHenry, IL 60050-8438
Phone (815) 363-9595

431 Summit St
Elgin, IL 60120-3805
Phone (847) 289-8822

600 Hart Rd
Suite 320
Barrington, IL 60010-2603
Phone (847) 852-2000

Hospital & facility affiliations

  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-009892ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Pain Treatment Institute, LTD CurrentSince Aug 14, 2025 Accepting new patients
Illinois Pain Treatment Institute, LTD CurrentSince Aug 14, 2025 Accepting new patients
Barrington Pain and Spine Institute, LLC Past Accepting new patients

Locations

600 Hart Rd
Ste 320
Barrington, IL 60010
Phone (847) 852-2000

431 Summit St
Ste 101
Elgin, IL 60120
Phone (847) 289-8822

22285 N Pepper Rd
Ste 302
Lake Barrington, IL 60010
Phone (847) 726-0774

755 S Milwaukee Ave
Ste 175
Libertyville, IL 60048
Phone (847) 680-7002

4309 W Medical Center Dr
Ste B103
McHenry, IL 60050
Phone (815) 363-9595

2455 Dean St
Ste 3G
St Charles, IL 60175
Phone (630) 254-8872

Organizations & group practices 6

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 7

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": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1417639337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 FLORSHEIM DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483757",
            "telephone_number": "847-247-4000",
            "fax_number": "847-234-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAGOYA",
        "first_name": "JIMMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-009892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.