Individual provider Active NPI

Jason Radke, MMS, PA-C

  • Medical Physician Assistant
  • Hoffman Estates, IL
National Provider Identifier
1902006687
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-002844 Issued in IL
Practice address
1585 Barrington Rd
Suite 505
Hoffman Estates, IL 60169-1090
Phone
(847) 839-7522
Fax
(847) 885-4568
NPI assigned
Jul 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085-002844 IL Primary

Addresses

Primary practice location

1585 Barrington Rd
Suite 505
Hoffman Estates, IL 60169-1090

Mailing address

1585 Barrington Rd
Suite 505
Hoffman Estates, IL 60169-1090
Phone (847) 839-7522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
085-002844ILMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1902006687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 BARRINGTON RD",
            "address_2": "SUITE 505",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691090",
            "telephone_number": "847-839-7522",
            "fax_number": "847-885-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 BARRINGTON RD",
            "address_2": "SUITE 505",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691090",
            "telephone_number": "847-839-7522",
            "fax_number": "847-885-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-002844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.