NPIMap

Individual provider Active NPI

Jessica Marie Dakhoul, PA-C

  • Physician Assistant
  • New Lenox, IL
National Provider Identifier
1932741824
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007350 Issued in IL
Practice address
678 Cedar Crossing Dr
New Lenox, IL 60451
Phone
(815) 723-9278
Fax
(815) 723-9819
NPI assigned
Oct 11, 2019
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 085007350 IL Primary

Addresses

Primary practice location

678 Cedar Crossing Dr
New Lenox, IL 60451

Mailing address

9921 Southwest Hwy
Oak Lawn, IL 60453-3754
Phone (708) 499-5678

Other practice location 1

9921 Southwest Hwy
Oak Lawn, IL 60453-3754
Phone (708) 499-5678

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gipartners@directaddress.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191226001135 IL Practitioner - Physician Assistant 0042644163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gi Partners of Illinois PLLCGroup PAC ID 2567758295, 38 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1880 W Winchester Rd
Suite 201
Libertyville, IL 60048-5336
Phone (847) 247-0187

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

9921 Southwest Hwy
Oak Lawn, IL 60453-3754
Phone (708) 499-5678

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: gipartners@directaddress.net
  • Direct secure messaging: jpoadpa309712@carlehiedirect.net

Organizations & group practices 4

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 6

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": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1932741824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 SOUTHWEST HWY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533754",
            "telephone_number": "708-499-5678",
            "fax_number": "708-499-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 CEDAR CROSSING DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "60451",
            "telephone_number": "815-723-9278",
            "fax_number": "815-723-9819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9921 Southwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533754",
            "country_code": "US",
            "telephone_number": "708-499-5678",
            "fax_number": "708-499-5685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAKHOUL",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gipartners@directaddress.net",
            "affiliation": "N",
            "address_1": "678 Cedar Crossing DR",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.