Active NPI
Justin Poole, PA-C
- Physician Assistant
- Melrose Park, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 8321 W North Ave
Melrose Park, IL 60160-1669 - Phone
- (708) 681-2298
- NPI assigned
- Jun 13, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | IL | ||
| Physician Assistant | 363A00000X | IL | Primary |
Addresses
Primary practice location
8321 W North Ave
Melrose Park, IL 60160-1669
Mailing address
8321 W North Ave
Melrose Park, IL 60160-1669
Phone (708) 681-2298
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7450 W 63Rd St
Des Plaines Valley Family Health Center
Summit, IL 60501-1816
Phone (708) 458-0757
8321 W N Ave
Melrose Park Family Health Center
Melrose Park, IL 60160-1605
Phone (708) 681-2298
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Past | Accepting new patients |
Locations
600 W Fulton St
Ste 300
Chicago, IL 60661
8321 W North Ave
Melrose Park, IL 60160
Phone (708) 681-2298
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Des Plaines, IL
- NPI 1982783692
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1699701383
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1841661089
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1043398217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1982447470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8321 W NORTH AVE",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601601669",
"telephone_number": "708-681-2298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8321 W NORTH AVE",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601601669",
"telephone_number": "708-681-2298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLE",
"first_name": "JUSTIN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-13",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.