Individual provider Active NPI

Jeremy Daniel Golon, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1437865680
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1725 W Harrison St Ste 970
Chicago, IL 60612-3828
Phone
(414) 630-7410
NPI assigned
Jan 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X IL
Surgical Physician Assistant 363AS0400X WI
Physician Assistant 363A00000X WI Primary

Addresses

Primary practice location

1725 W Harrison St Ste 970
Chicago, IL 60612-3828

Mailing address

11203 W Abbott Ave
Hales Corners, WI 53130-1211
Phone (414) 630-7410

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
I20230515001999 IL Practitioner - Physician Assistant 7416313671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1411 S Michigan Ave
Chicago, IL 60605-2810

1653 W Congress Pkwy
Chicago, IL 60612-3833

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

1725 W Harrison St
Suite 955
Chicago, IL 60612-3862
Phone (312) 942-7030

1725 W Harrison St
Suite 970
Chicago, IL 60612-3828
Phone (312) 563-3447

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince May 15, 2023 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 425
Chicago, IL 60612
Phone (312) 563-2558

1411 S Michigan Ave
Chicago, IL 60605
Phone (312) 454-2700

1725 W Harrison St
Ste 970
Chicago, IL 60612
Phone (312) 563-3447

1725 W Harrison St
Ste 352
Chicago, IL 60612
Phone (312) 563-3447

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

610 S Maple Ave
Ste 3450
Oak Park, IL 60304
Phone (312) 563-3447

Organizations & group practices 1

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 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": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1437865680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11203 W ABBOTT AVE",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301211",
            "telephone_number": "414-630-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 970",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123828",
            "telephone_number": "414-630-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLON",
        "first_name": "JEREMY",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.