Individual provider Active NPI

Jonathan Sebastian Cordova, D.O.

  • Pediatrics Physician
  • Maywood, IL
National Provider Identifier
1609195601
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036132010 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
May 31, 2010
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036132010 IL Primary
Pediatric Gastroenterology Physician 2080P0206X 036132010 IL

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

3232 Lake Ave Ste 330
Wilmette, IL 60091-1085
Phone (847) 570-1795

Other practice location 1

225 E Chicago Ave
Chicago, IL 60611-2991
Phone (800) 543-7362

Other practice location 2

880 W Central Rd Ste 6400
Arlington Heights, IL 60005-2378
Phone (800) 543-7362

Other practice location 3

1131 Techny Rd
Northbrook, IL 60062-5503
Phone (800) 543-7362

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcordova261249@direct.northshore.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613001115 IL Practitioner - Pediatric MedicinePractitioner - Gastroenterology 0648574285 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036132010ILMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Mar 1, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 1, 2016 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Endeavor Health Medical Group Pediatrics CurrentSince Jul 1, 2016 Accepting new patients

Locations

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

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

2150 Pfingsten Rd
Ste 3000
Glenview, IL 60026
Phone (847) 657-1700

2180 Pfingsten Rd
Ste B000
Glenview, IL 60026

3232 Lake Ave
Ste 330
Wilmette, IL 60091
Phone (224) 226-9420

Organizations & group practices 6

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": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1609195601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 LAKE AVE STE 330",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911085",
            "telephone_number": "847-570-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "800-543-7362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "880 W Central Rd Ste 6400",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600052378",
            "country_code": "US",
            "telephone_number": "800-543-7362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1131 Techny Rd",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600625503",
            "country_code": "US",
            "telephone_number": "800-543-7362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "JONATHAN",
        "middle_name": "SEBASTIAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-31",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036132010",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IL",
            "license": "036132010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcordova261249@direct.northshore.org",
            "affiliation": "N",
            "address_1": "3232 Lake Ave Ste 330",
            "city": "Wilmette",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600911085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.