Jsa of Illinois PC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

JSA OF ILLINOIS PC

Practice address

309 E Rand Rd
Suite 347
Arlington Heights, IL 60004-3103

Phone

(678) 983-4479

NPI assigned

May 11, 2011

Organization subpart

No

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

Authorized official

Name

Ann Schaker

Title

Billing Director

Phone

(678) 983-4479

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1689966533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 543",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300090543",
            "telephone_number": "678-983-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E RAND RD",
            "address_2": "SUITE 347",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600043103",
            "telephone_number": "678-983-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSA OF ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "SCHAKER",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "678-983-4479"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.