Individual provider Active NPI

Hannah Kathryn Jeffrey, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1417672643
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009180 Issued in IL
Practice address
3245 N Halsted St
Chicago, IL 60657-3419
Phone
(773) 388-1600
NPI assigned
Oct 10, 2022
Last updated
Oct 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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 085.009180 IL Primary

Addresses

Primary practice location

3245 N Halsted St
Chicago, IL 60657-3419

Mailing address

3245 N Halsted St
Chicago, IL 60657-3419
Phone (773) 388-1600

Other identifiers 1

IdentifierTypeStateIssuer
085.009180MedicaidIL

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
I20221025000616 IL Practitioner - Physician Assistant 2860868304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard Brown Health CenterGroup PAC ID 1052203155, 52 clinicians

Practice addresses (Care Compare)

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.009180ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center CurrentSince Sep 5, 2022 Accepting new patients
Howard Brown Health Center CurrentSince Sep 5, 2022 Accepting new patients
Howard Brown Health Center Past Accepting new patients
Howard Brown Health Center Past Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

1025 W Sunnyside Ave
Ste 100
Chicago, IL 60640

3245 N Halsted St
Chicago, IL 60657
Phone (773) 248-3160

3501 N Halsted St
Chicago, IL 60657
Phone (773) 248-3160

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

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

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1417672643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573419",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573419",
            "telephone_number": "773-388-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREY",
        "first_name": "HANNAH",
        "middle_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085.009180",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.