Active NPI
Joseph Serafin
- Physician Assistant
- Tinley Park, IL
National Provider Identifier
1699276725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085006575
- Practice address
- 16112 Princeton Ave
Tinley Park, IL 60477-6730 - Phone
- (708) 620-0174
- NPI assigned
- Feb 23, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085006575 | IL | Primary |
| Physician Assistant | 363A00000X | 8898-23 | WI |
Addresses
Primary practice location
16112 Princeton Ave
Tinley Park, IL 60477-6730
Mailing address
16112 Princeton Ave
Tinley Park, IL 60477-6730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1699276725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16112 PRINCETON AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604776730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16112 PRINCETON AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604776730",
"telephone_number": "708-620-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERAFIN",
"first_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-23",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085006575",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "8898-23",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.