Shannon Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-010958 Issued in IL

Practice address

430 Pennsylvania Ave Ste 240
Glen Ellyn, IL 60137-4464

Phone

(630) 790-1872

Fax

(630) 545-7850

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward Hospital Hospital, Naperville, IL, CCN 140231

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjohnson301856@dulyhealthandcare.direct-ci.com

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.

• Dupage Medical Group LTD

  dba DuPage Medical Group

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Lockport, IL
  • NPI 1568077212
  NPD (past)

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

• Edward Hospital

  dba Endeavor Health Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1811675317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 7132960",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770001",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 PENNSYLVANIA AVE STE 240",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374464",
            "telephone_number": "630-790-1872",
            "fax_number": "630-545-7850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10900 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061712",
            "country_code": "US",
            "telephone_number": "216-368-0575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANNON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-010958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjohnson301856@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "430 Pennsylvania Ave Ste 240",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601374464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Lynn Gibbs, DDS, P.C.
• Jessica Lynn Gibbs, DDS, P.C. (Smile Glen Ellyn)
• Zoe Argiro Johnsen, MS CF SLP
• Marilanne Johnson, MD
• Nika Marie Johnson, PT
• Charita Jones, LMT,NCTMB
• William Brent Jones, MSW
• Katina Jonkman
• Katherine Jost, MA
• Robert Milton Jourdan, D.D.S.

• Physician Assistant in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.