Individual provider Active NPI

Jordon W. Thomsen, PA-C

  • Physician Assistant
  • Evanston, IL
National Provider Identifier
1447746805
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007859 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-2023
NPI assigned
Jul 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4556-23 WI
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 085007859 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

6308 8th Ave
Kenosha, WI 53143-5031
Phone (414) 290-6720

Other practice location 2

734 2nd Ave NW
Valley City, ND 58072-2506
Phone (701) 840-1565

Other practice location 3

9555 76th St
Pleasant Prairie, WI 53158-1984
Phone (414) 290-6720

Other practice location 4

5145 N California Ave
Chicago, IL 60625-3661
Phone (847) 570-1027

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
I20220613002814 IL Practitioner - Physician Assistant 5395080162 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085007859ILMDPhysician Assistant
4556-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince May 1, 2025 Accepting new patients
Inpatient Consultants of Illinois, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Cook County CurrentSince May 19, 2022 Accepting new patients
Cook County CurrentSince May 19, 2022 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

Organizations & group practices 7

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 1

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": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1447746805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6308 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531435031",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "734 2nd Ave NW",
            "address_purpose": "LOCATION",
            "city": "Valley City",
            "state": "ND",
            "postal_code": "580722506",
            "country_code": "US",
            "telephone_number": "701-840-1565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9555 76th St",
            "address_purpose": "LOCATION",
            "city": "Pleasant Prairie",
            "state": "WI",
            "postal_code": "531581984",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5145 N California Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606253661",
            "country_code": "US",
            "telephone_number": "847-570-1027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMSEN",
        "first_name": "JORDON",
        "middle_name": "W.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-09",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4556-23",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.