Individual provider Active NPI

Jessica Lin Draus, DO

  • Family Medicine Physician
  • Alton, IL
National Provider Identifier
1902649163
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.084065 Issued in IL
Practice address
2 Memorial Dr
Medical Office BLDG, a, Suite 220
Alton, IL 62002-6705
Phone
(618) 474-1723
Fax
(618) 433-6299
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.084065 IL Primary

Addresses

Primary practice location

2 Memorial Dr
Medical Office BLDG, a, Suite 220
Alton, IL 62002-6705

Mailing address

2 Memorial Dr
Medical Office BLDG, a, Suite 220
Alton, IL 62002-6705
Phone (618) 474-1723

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628002874 IL Order and Referring Only - Family PracticePractitioner - Family Practice 7911441159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: jessica.draus.1@9559.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1902649163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DR",
            "address_2": "MEDICAL OFFICE BLDG, A, SUITE 220",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026705",
            "telephone_number": "618-474-1723",
            "fax_number": "618-433-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DR",
            "address_2": "MEDICAL OFFICE BLDG, A, SUITE 220",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026705",
            "telephone_number": "618-474-1723",
            "fax_number": "618-433-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAUS",
        "first_name": "JESSICA",
        "middle_name": "LIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.084065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.