Jaclyn Novak

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5645 W Addison St
Chicago, IL 60634-4403

Phone

(773) 282-7000

NPI assigned

May 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Community First Healthcare of Illinois, Inc.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1881059897
  Medicare reassignment
• Osf Healthcare System

  • Certified Registered Nurse Anesthetist
  • Monmouth, IL
  • NPI 1811016124
  Medicare reassignment
• Community First Healthcare of Illinois, Inc.

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1053102269
  NPD
• Community First Healthcare of Illinois, Inc.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1962894675
  NPD
• Osf Healthcare System

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1457916124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "773-282-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "JACLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad Jefferey Novak, MA, LCPC
• Debra Ann Novak, RN, IBCLC
• Diane Novak, CCC-A
• Elizabeth Ann Novak, CT
• Jaclyn Novak, APN
• Jennifer Novak, MS, CCC-SLP
• Jennifer Jean Novak, LCPC
• Karen Novak, NP
• Laura Novak, DPT
• Mary Fran Novak, CRNA

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.