Jennifer Kang
Individual provider Active NPI Surgical Physician Assistant · Riverside, IL
NPI 1912307448 · NPPES record last updated Sep 3, 2014
Key facts
- NPI
- 1912307448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 085005188 (IL)
- Practice address
- 353 E Burlington St
Suite 100
Riverside, IL 60546-2189 - Phone
- (708) 442-0221
- Fax
- (708) 442-5670
- NPI assigned
- Sep 3, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwestern Medical Faculty Foundation
Practice addresses (Care Compare)
12251 S 80TH Ave
Palos Heights, IL 60463-1290
15300 W Ave
Orland Park, IL 60462-4600
675 N Saint Clair St
Chicago, IL 60611-5975
675 N St Clair
Chicago, IL 60611-5975
Hospital & facility affiliations
- Palos Community Hospital
- Northwestern Medicine Central Dupage Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141016001449 | IL | Practitioner - Physician Assistant | 7810118858 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| Central Dupage Physician Group | Current |
Accepting new patients | |
| Midland Orthopedic Associates PLLC | Past |
Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
4309 W Medical Center Dr
Ste B301
McHenry, IL 60050
Phone (847) 535-6083
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
15300 West Ave
Ste 108
Orland Park, IL 60462
Phone (708) 226-2318
12255 S 80th Ave
Ste 204
Palos Heights, IL 60463
Phone (708) 923-4400
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 085005188 | IL | Yes |
Addresses
Primary practice location
353 E Burlington St
Suite 100
Riverside, IL 60546-2189
Mailing address
353 E Burlington St
Suite 100
Riverside, IL 60546-2189
Phone (708) 442-0221
Other providers in Riverside, IL
- Jan Szatkowski MD and Barbara Zabska MD SC
- Deborah P Jensen
- Jewel Pharmacy RX Corp
- K Shurtleff Therapy and Life Coaching
- Ernest Kaminski
- Deepika Karki
- Nithya Karpagavinayagam
- Nicole Kasperek
- Amy Lee Kienow Paychek
- Martin Peter Kornak
All providers in Riverside, IL · Surgical Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.