Jai Jung Nho, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036052229 Issued in IL

Practice address

15 Commerce Dr Ste 113
Grayslake, IL 60030-7807

Phone

(847) 231-5300

Fax

(847) 231-5303

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

26.52 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

88.39

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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.

• Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
  • NPI 1306937289
  Medicare reassignment NPD
• Oncology Hematology Associates of Northern Illinois, LTD

  • Hematology & Oncology Physician
  • Gurnee, IL
  • NPI 1093142135
  NPD

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1780670018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 COMMERCE DR STE 113",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307807",
            "telephone_number": "847-231-5300",
            "fax_number": "847-231-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 COMMERCE DR STE 113",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307807",
            "telephone_number": "847-231-5300",
            "fax_number": "847-231-5303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Tower Ct Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600313355",
            "country_code": "US",
            "telephone_number": "847-623-7343",
            "fax_number": "847-623-1950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NHO",
        "first_name": "JAI",
        "middle_name": "JUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036052229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "036052229",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0491507812",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052229",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.