NPIMap

Organization Active NPI

Sycamore Medical Associates LLC

Doing business as Northern Illinois Medical Associates

  • Family Medicine Physician
  • Sycamore, IL
National Provider Identifier
1770916777
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036098973 Issued in IL
Legal business name
SYCAMORE MEDICAL ASSOCIATES LLC
Doing business as
Northern Illinois Medical Associates
Practice address
2560 Hauser Ross Dr
Suite 450
Sycamore, IL 60178-3150
Phone
(815) 748-3040
Fax
(815) 748-3070
NPI assigned
Aug 13, 2013
Last updated
Jun 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
Jamison D Allen, D.O.NPI 1184614760
Title
Co-Owner
Phone
(815) 748-3040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004109 IL
Family Medicine Physician 207Q00000X 036098973 IL Primary
Internal Medicine Physician 207R00000X 036103130 IL

Addresses

Primary practice location

2560 Hauser Ross Dr
Suite 450
Sycamore, IL 60178-3150

Mailing address

2560 Hauser Ross Dr
Suite 450
Sycamore, IL 60178-3150
Phone (815) 748-3040

Other names 1

  • Northern Illinois Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131028001189 IL Part B Supplier - Clinic/Group Practice 3274767686 Receives reassigned benefits from 26 practitioners
Practice locations: Dekalb, IL; Sycamore, IL; Geneva, IL; Elgin, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2131057Sycamore Medical Associates LLC2560 Hauser Ross Dr, Ste 450, Sycamore, IL 60178Certificate of waiverMay 21, 2027

National Provider Directory

National Provider Directory

Locations

2560 Hauser Ross Dr
Sycamore, IL 60178

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FABCDA

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1770916777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 HAUSER ROSS DR",
            "address_2": "SUITE 450",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783150",
            "telephone_number": "815-748-3040",
            "fax_number": "815-748-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 HAUSER ROSS DR",
            "address_2": "SUITE 450",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783150",
            "telephone_number": "815-748-3040",
            "fax_number": "815-748-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORE MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-13",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JAMISON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "815-748-3040",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004109",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036098973",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036103130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Illinois Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.