Individual provider Active NPI

Jeslyn Chamakalayil Joseph, PA-C

  • Physician Assistant
  • Skokie, IL
National Provider Identifier
1447923214
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008702 Issued in IL
Practice address
9977 Woods Dr Ste 100
Skokie, IL 60077-1057
Phone
(224) 364-2273
Fax
(847) 663-8290
NPI assigned
Jul 28, 2021
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 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 085008702 IL Primary

Addresses

Primary practice location

9977 Woods Dr Ste 100
Skokie, IL 60077-1057

Mailing address

9977 Woods Dr Ste 100
Skokie, IL 60077-1057
Phone (224) 364-2273

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
I20220427001654 IL Practitioner - Physician Assistant 2062809734 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
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1162 W Maple Ave
Mundelein, IL 60060-1438
Phone (847) 367-2400

1329 N Wolf Rd
Mount Prospect, IL 60056-1500
Phone (847) 803-3040

1535 Ellinwood Ave
Des Plaines, IL 60016-4553
Phone (224) 364-2273

211 Waukegan Rd
Suite 200
Northfield, IL 60093-2724
Phone (847) 767-3718

2650 Ridge Ave
Evanston, IL 60201-1700

4901 Searle Pkwy
Suite 150
Skokie, IL 60077-1057

501 Skokie Blvd
Northbrook, IL 60062-2802
Phone (847) 504-2300

524 Main St
Evanston, IL 60202-1815
Phone (224) 364-2273

6141 N Cicero Ave
Chicago, IL 60646-4303
Phone (847) 866-7846

6450 W Touhy Ave
Niles, IL 60714-4512

71 Waukegan Rd
Suite 700
Lake Bluff, IL 60044-1614
Phone (224) 364-2273

9977 Woods Dr
Skokie, IL 60077-1057
Phone (847) 663-8062

9977 Woods Dr 2ND Floor
Skokie, IL 60077-1057
Phone (847) 663-8370

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 17, 2022 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

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

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

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

9977 Woods Dr
Ste 100
Skokie, IL 60077

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1447923214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 100",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273",
            "fax_number": "847-663-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 100",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273",
            "fax_number": "847-663-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMAKALAYIL JOSEPH",
        "first_name": "JESLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.