Nicole Marie Jano, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.010687 Issued in IL

Practice address

303 E Army Trail Rd Ste 304
Bloomingdale, IL 60108-2152

Phone

(630) 893-9661

NPI assigned

Sep 11, 2023

Last updated

Jul 28, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 14, 2024 through Oct 14, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  NPD (past)

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1700663994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD STE 304",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082152",
            "telephone_number": "630-893-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD STE 304",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082152",
            "telephone_number": "630-893-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANO",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5774",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnieszka Jackson
• Betsy Jacob, APN
• Susan Jacob, M.C.
• Jaffery Eyecare
• Syed Jaffery
• Gregory M Jansyn, DPM
• Cristiane Gurgel DO Amaral Jereissati
• Andre Jham
• Raquel Martuchi Jham, D.D.S.
• Elizabeth Anne Johansson, LCPC

• Physician Assistant in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.