Individual provider Active NPI

Jessica Sefton, PA

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1851812788
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3461 Momentum PL
Chicago, IL 60689-0001
Phone
(847) 624-3781
Fax
(847) 816-6945
NPI assigned
Jun 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 IL Primary

Addresses

Primary practice location

3461 Momentum PL
Chicago, IL 60689-0001

Mailing address

178 W Fox Hill Drive
Buffalo, IL 60089
Phone (630) 677-3814

Other identifiers 1

IdentifierTypeStateIssuer
085.006304OtherILPA LICENSE

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
I20171128001316 IL Practitioner - Physician Assistant 9638436736 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake County Immediate Care, LLCGroup PAC ID 6204158280, 15 clinicians

Practice addresses (Care Compare)

1849 Green Bay Rd
Suite 171
Highland Park, IL 60035-3152
Phone (847) 901-8400

724 N Green Bay Rd
Waukegan, IL 60085-2236
Phone (847) 901-8400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Immediate Care, LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

1849 Green Bay Rd
Ste 171
Highland Park, IL 60035
Phone (847) 901-8400

724 N Green Bay Rd
Waukegan, IL 60085
Phone (847) 901-8400

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851812788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 W FOX HILL DRIVE",
            "city": "BUFFALO",
            "state": "IL",
            "postal_code": "60089",
            "telephone_number": "630-677-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3461 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606890001",
            "telephone_number": "847-624-3781",
            "fax_number": "847-816-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEFTON",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "085.006304",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.