Individual provider Active NPI

Glennon Lee Johnston, PA-C

  • Physician Assistant
  • Aurora, IL
National Provider Identifier
1871830141
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004497 Issued in IL
Practice address
1325 N Highland Ave
Aurora, IL 60506-1449
Phone
(630) 875-2222
NPI assigned
Jan 7, 2013
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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 085004497 IL Primary

Addresses

Primary practice location

1325 N Highland Ave
Aurora, IL 60506-1449

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

303 W Lake St
Addison, IL 60101-2586
Phone (630) 527-3645

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
I20130415000283 IL Practitioner - Physician Assistant 3971749136 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085004497ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Hospital CurrentSince Aug 4, 2014 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 30, 2023 Accepting new patients
Edward Health Ventures CurrentSince Jul 1, 2020 Accepting new patients
Cepamerica Illinois LLP CurrentSince Mar 1, 2026 Accepting new patients
Cepamerica Illinois LLP CurrentSince Mar 1, 2026 Accepting new patients
Edward Hospital CurrentSince Aug 4, 2014 Accepting new patients
Edward Health Ventures CurrentSince Jul 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

303 W Lake St
Addison, IL 60101
Phone (331) 221-1705

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

3033 Ogden Ave
Ste 101
Lisle, IL 60532
Phone (630) 646-6200

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

6701 US Highway 34
Oswego, IL 60543
Phone (630) 646-4200

Interoperability endpoints

  • Direct secure messaging: gjohnston43973@direct.edward.org
  • FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1871830141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061449",
            "telephone_number": "630-875-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 W Lake St",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "IL",
            "postal_code": "601012586",
            "country_code": "US",
            "telephone_number": "630-527-3645",
            "fax_number": "331-221-3983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "GLENNON",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.