Individual provider Active NPI

Sharon Shajan Chacko

  • Physician Assistant
  • Carpentersville, IL
National Provider Identifier
1700712106
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6678 Majestic Way
Carpentersville, IL 60110-3441
Phone
(224) 623-9732
NPI assigned
Jun 23, 2026
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

6678 Majestic Way
Carpentersville, IL 60110-3441

Mailing address

6678 Majestic Way
Carpentersville, IL 60110-3441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1782172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1700712106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6678 MAJESTIC WAY",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601103441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6678 MAJESTIC WAY",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601103441",
            "telephone_number": "224-623-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "SHARON",
        "middle_name": "SHAJAN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-06-23",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carpentersville, IL

Sources for this page

Verify at the official NPI Registry.