Individual provider Active NPI

Disha Japa

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1629696752
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
939 W North Ave Ste 650
Chicago, IL 60642-8684
Phone
(773) 377-8000
NPI assigned
Jul 6, 2020
Reactivated
Nov 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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 IL Primary

Addresses

Primary practice location

939 W North Ave Ste 650
Chicago, IL 60642-8684

Mailing address

939 W North Ave Ste 650
Chicago, IL 60642-8684
Phone (773) 377-8000

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
I20251208002052 IL Practitioner - Physician Assistant 5991299984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mid West Medical College, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
I2 Medicine LLCGroup PAC ID 4789914920, 5 clinicians

Practice addresses (Care Compare)

939 W N Ave
Suite 650
Chicago, IL 60642-8684
Phone (773) 377-8000

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
I2 Medicine LLC CurrentSince Nov 26, 2025 Accepting new patients
Specialty Integrative Nutrition, LLC CurrentSince Nov 24, 2025 Accepting new patients

Locations

939 W North Ave
Ste 650
Chicago, IL 60642
Phone (773) 377-8000

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 and National Provider Directory roles.

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1629696752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 W NORTH AVE STE 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606428684",
            "telephone_number": "773-377-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 W NORTH AVE STE 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606428684",
            "telephone_number": "773-377-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAPA",
        "first_name": "DISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "deactivation_date": "2025-10-28",
        "reactivation_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.