Jill a. Patterson, MD SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036084102 Issued in IL

Legal business name

JILL A. PATTERSON, MD SC

Practice address

11148 Front St
Mokena, IL 60448-1525

Phone

(708) 478-5763

Fax

(708) 478-8763

NPI assigned

Oct 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jill A. Patterson, MDNPI 1083642557

Title

President

Phone

(708) 478-5763

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Generation Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jill a. Patterson, MD, S.C.

  • Clinic/Center
  • Mokena, IL
  • NPI 1932400041
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill A Patterson, MD

  • Family Medicine Physician
  • Mokena, IL
  • NPI 1083642557
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1801106398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11148 FRONT ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481525",
            "telephone_number": "708-478-5763",
            "fax_number": "708-478-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11148 FRONT ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481525",
            "telephone_number": "708-478-5763",
            "fax_number": "708-478-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL A. PATTERSON, MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-478-5763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036084102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1083642557",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "40755",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084102",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Janik, PMHNP
• Jaimie Janik, FNP
• Paulette J Jarke
• Theodore B Jefferson, M.D.
• JG Eyecare,LTD
• Jill a. Patterson, MD, S.C.
• Sara Anne Johns, P.T.
• Anastasia Marie Johnson, PHARMD
• Jennifer Johnson, NP-C
• Megan Rose Johnson, M.S.

• Family Medicine Physician in Mokena, IL
• Providers in Mokena, 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 Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.