Individual provider Active NPI

Julie Mather Jourdan, PA-C

  • Physician Assistant
  • Oakbrook Terrace, IL
National Provider Identifier
1962647917
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.002372 Issued in IL
Practice address
1S224 Summit Ave
Suite 106
Oakbrook Terrace, IL 60181-3983
Phone
(630) 953-1190
NPI assigned
Dec 4, 2008
Last updated
Dec 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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 085.002372 IL Primary

Addresses

Primary practice location

1S224 Summit Ave
Suite 106
Oakbrook Terrace, IL 60181-3983

Mailing address

1S224 Summit Ave
Suite 106
Oakbrook Terrace, IL 60181-3983
Phone (630) 953-1190

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
I20090414000756 IL Practitioner - Physician Assistant 6204983935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Oakbrook Terrace SCGroup PAC ID 4981925443, 3 clinicians

Practice addresses (Care Compare)

1 S224 Summit Ave
Suite 106
Oakbrook Terrace, IL 60181-3944
Phone (630) 953-1190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.002372ILMDPhysician Assistant

Organizations & group practices 1

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 1

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": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1962647917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S224 SUMMIT AVE",
            "address_2": "SUITE 106",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813983",
            "telephone_number": "630-953-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S224 SUMMIT AVE",
            "address_2": "SUITE 106",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813983",
            "telephone_number": "630-953-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOURDAN",
        "first_name": "JULIE",
        "middle_name": "MATHER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.002372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

Verify at the official NPI Registry.