Individual provider Active NPI

Alishia Davison, PA-C

  • Physician Assistant
  • Joliet, IL
National Provider Identifier
1760810915
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-004881 Issued in IL
Practice address
1051 Essington Rd
Suite 290
Joliet, IL 60435-2801
Phone
(815) 773-0099
Fax
(815) 773-0088
NPI assigned
Oct 25, 2013
Last updated
Aug 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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 085-004881 IL Primary

Addresses

Primary practice location

1051 Essington Rd
Suite 290
Joliet, IL 60435-2801

Mailing address

1051 Essington Rd
Suite 290
Joliet, IL 60435-2801
Phone (815) 773-0099

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
I20140512000690 IL Practitioner - Physician Assistant 9537392857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

2425 Fargo Blvd
Geneva, IL 60134-3591
Phone (630) 232-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-004881ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Nov 1, 2022 Accepting new patients
Health Service Systems, Inc CurrentSince Dec 30, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince Nov 1, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2425 Fargo Blvd
Geneva, IL 60134
Phone (630) 232-2200

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1760810915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD",
            "address_2": "SUITE 290",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352801",
            "telephone_number": "815-773-0099",
            "fax_number": "815-773-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD",
            "address_2": "SUITE 290",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352801",
            "telephone_number": "815-773-0099",
            "fax_number": "815-773-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "ALISHIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-25",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-004881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.