Active NPI
Jincy K Joseph, MD
- Family Medicine Physician
- Carpentersville, IL
National Provider Identifier
1720009228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036116215
- Practice address
- 2201 Randall Rd
Carpentersville, IL 60110-3355 - Phone
- (847) 695-3200
- NPI assigned
- Jul 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036116215 | IL | Primary |
Addresses
Primary practice location
2201 Randall Rd
Carpentersville, IL 60110-3355
Mailing address
1942 Dempster St
Evanston, IL 60202-1016
Phone (847) 688-1900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036116215 | Medicaid | IL | |
| 2232882 | Other | IL | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036116215 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Women'S Doc of Elgin, S. C. | Family Medicine | Past | Accepting new patients |
| Women'S Comprehensive Healthcare, S.C. | Past | Accepting new patients |
Interoperability endpoints
- jincy.joseph.1@3569.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
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- Hoffman Estates, IL
- NPI 1639101033
-
- Obstetrics & Gynecology Physician
- Elgin, IL
- NPI 1295763886
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1720009228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1942 DEMPSTER ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602021016",
"telephone_number": "847-688-1900",
"fax_number": "224-610-8595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 RANDALL RD",
"city": "CARPENTERSVILLE",
"state": "IL",
"postal_code": "601103355",
"telephone_number": "847-695-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "JINCY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036116215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036116215",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "2232882",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carpentersville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.