Individual provider Active NPI

Amber N Eisterhold, PA-C

  • Surgical Physician Assistant
  • Palos Hills, IL
National Provider Identifier
1932968120
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085010363 Issued in IL
Practice address
10330 S Roberts Rd
Palos Hills, IL 60465-1971
Phone
(708) 237-7200
Fax
(708) 237-7201
NPI assigned
Mar 18, 2024
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085010363 IL Primary

Addresses

Primary practice location

10330 S Roberts Rd
Palos Hills, IL 60465-1971

Mailing address

10330 S Roberts Rd
Palos Hills, IL 60465-1971
Phone (708) 237-7200

Other practice location 1

19065 Hickory Creek Dr Ste 300
Mokena, IL 60448-8599
Phone (708) 237-7200

Other identifiers 1

IdentifierTypeStateIssuer
085-010363OtherILPA LICENSE

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
I20240514000483 IL Practitioner - Physician Assistant 7618318262 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085010363ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midamerica Orthopaedics, S.C. CurrentSince Apr 29, 2024 Accepting new patients
Midamerica Orthopaedics S.C. CurrentSince Apr 29, 2024 Accepting new patients

Locations

19065 Hickory Creek Dr
Ste 210
Mokena, IL 60448
Phone (708) 237-7200

19065 Hickory Creek Dr
Ste 300
Mokena, IL 60448
Phone (708) 237-7200

10330 S Roberts Rd
Palos Hills, IL 60465
Phone (708) 237-7200

Interoperability endpoints

  • Direct secure messaging: aeisterhold@mo1800.srs-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1932968120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651971",
            "telephone_number": "708-237-7200",
            "fax_number": "708-237-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 S ROBERTS RD",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651971",
            "telephone_number": "708-237-7200",
            "fax_number": "708-237-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19065 Hickory Creek Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488599",
            "country_code": "US",
            "telephone_number": "708-237-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISTERHOLD",
        "first_name": "AMBER",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085010363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "085-010363",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Hills, IL

Sources for this page

Verify at the official NPI Registry.