Individual provider Active NPI

Jill C Georgen, PA-C

  • Physician Assistant
  • Grafton, WI
National Provider Identifier
1669092730
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5308 Issued in WI
Practice address
975 Port Washington Rd
Grafton, WI 53024-9201
Phone
(262) 329-1000
NPI assigned
Apr 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085.008000 IL
Physician Assistant 363A00000X 5308 WI Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 085.008000 IL

Addresses

Primary practice location

975 Port Washington Rd
Grafton, WI 53024-9201

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

32 Marengo Ave Unit B
Forest Park, IL 60130-1107
Phone (920) 574-1827

Other practice location 2

10 Martin Ave Ste 225
Naperville, IL 60540-6590
Phone (630) 284-9118

Other identifiers 1

IdentifierTypeStateIssuer
100216756MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jgeorgen355307@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210302000368 IL Practitioner - Physician Assistant 6901212869 Reassigns benefits to 1 organization
I20221025002108 WI Practitioner - Physician Assistant 6901212869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Hering Medical College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5308WIMDMental Health Counselor
085.008000ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Multi-Specialty CurrentSince Sep 30, 2022 Accepting new patients
Edward Health Ventures CurrentSince Mar 22, 2021 Accepting new patients
Edward Health Ventures Multi-Specialty CurrentSince Mar 22, 2021 Accepting new patients
Aurora Medical Group, Inc. Multi-Specialty CurrentSince Sep 30, 2022 Accepting new patients
Aurora Advanced Healthcare Inc Multi-Specialty CurrentSince Jan 1, 2023 Accepting new patients
Aurora Advanced Healthcare, Inc. Multi-Specialty CurrentSince Jan 1, 2023 Accepting new patients

Locations

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

10 Martin Ave
Ste 225
Naperville, IL 60540
Phone (630) 284-9118

4201 Winfield Rd
Fl 3
Warrenville, IL 60555

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

975 Port Washington Rd
Ste 320
Grafton, WI 53024
Phone (262) 329-1000

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

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": "1587254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1669092730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32 Marengo Ave Unit B",
            "address_purpose": "LOCATION",
            "city": "Forest Park",
            "state": "IL",
            "postal_code": "601301107",
            "country_code": "US",
            "telephone_number": "920-574-1827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Martin Ave Ste 225",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605406590",
            "country_code": "US",
            "telephone_number": "630-284-9118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGEN",
        "first_name": "JILL",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-19",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.008000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5308",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100216756",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgeorgen355307@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.