Individual provider Active NPI

Jamie Gradishar

  • Medical Physician Assistant
  • Chicago, IL
National Provider Identifier
1700668829
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.011104 Issued in IL
Practice address
1127 N Oakley Blvd FL 2
Chicago, IL 60622-3507
Phone
(312) 633-5841
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.011104 IL Primary

Addresses

Primary practice location

1127 N Oakley Blvd FL 2
Chicago, IL 60622-3507

Mailing address

1127 N Oakley Blvd FL 2
Chicago, IL 60622-3507
Phone (312) 633-5841

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
I20250226001747 IL Practitioner - Physician Assistant 3173043759 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Community Health Inc CurrentSince Feb 20, 2025 Accepting new patients
Primecare Community Health, Inc. CurrentSince Feb 20, 2025 Accepting new patients

Locations

1127 N Oakley Blvd
Fl 2
Chicago, IL 60622
Phone (312) 633-5841

3924 W Fullerton Ave
Chicago, IL 60647
Phone (773) 276-2229

5635 W Belmont Ave
Chicago, IL 60634
Phone (773) 622-8055

1649 N Pulaski Rd
Chicago, IL 60639
Phone (773) 278-6868

1127 N Oakley Blvd
Bldg 2
Chicago, IL 60622

1920 N Hamlin Ave
Chicago, IL 60647
Phone (773) 772-7202

1431 N Western Ave
Ste 202
Chicago, IL 60622
Phone (773) 276-2272

1431 N Western Ave
Ste 209
Chicago, IL 60622
Phone (312) 491-5435

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

Interoperability endpoints

  • Direct secure messaging: jamie.gradishar.1@16494.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1700668829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 N OAKLEY BLVD FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "312-633-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 N OAKLEY BLVD FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "312-633-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADISHAR",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.011104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.