Active NPI 1417283938 Individual Practitioner Female Practitioner

Haley Ranae Goulson , PA-C

Physician Assistant • Dekalb, IL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Haley Goulson, PA-C is a certified Physician Assistant practicing in Dekalb, IL. With approximately 17 years of clinical experience since completing medical education in 2009, Haley Goulson delivers high-quality medical care to the local community at 10 HEALTH SERVICES DR.

Haley Goulson is affiliated with Northwestern Medical Faculty Foundation and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, telephone medical discussion with physician, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

10 Health Services Dr

Dekalb, IL 601159600

Telephone 8157565255

Fax 8157569944

Associated Practice Facility / Clinic

🏢 Illinois Regional Cancer Center Llp Facility NPI 1760524995

Medicare Profile & Education

Medical School

Other

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Dekalb, IL

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs +5.0 yrs vs City Avg

City Avg: 12.0 Yrs

State Avg: 11.7 Yrs

Regional Practice Density

4 Specialists

Practicing in Dekalb, IL (4958 Statewide)

Telehealth Adoption Rate

25.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

65.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Goulson (17 Years) 17 Yrs

Dekalb Specialty Average (12.0 Years) 12.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	228	139	$323.00	$103.74
99213 Established patient office or other outpatient visit, typically 15 minutes	115	81	$219.00	$73.75
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	114	70	$434.00	$146.87
99442 Telephone medical discussion with physician, 11-20 minutes	53	45	$175.00	$72.55
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	38	24	$217.00	$64.63
99443 Telephone medical discussion with physician, 21-30 minutes	31	26	$250.00	$103.95
99231 Follow-up hospital inpatient care per day, typically 15 minutes	11	11	$119.00	$40.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	370	175	$199.93	$104.37
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	110	87	$277.05	$146.44
99213 Established patient office or other outpatient visit, typically 15 minutes	73	55	$126.95	$73.34
99442 Telephone medical discussion with physician, 11-20 minutes	61	39	$175.00	$73.72
99443 Telephone medical discussion with physician, 21-30 minutes	39	32	$250.00	$103.52
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	36	21	$145.00	$65.71
99231 Follow-up hospital inpatient care per day, typically 15 minutes	20	15	$102.00	$41.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	348	201	$194.00	$105.09
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	130	99	$268.00	$147.55
99213 Established patient office or other outpatient visit, typically 15 minutes	82	69	$123.00	$74.86
99442 Telephone medical discussion with physician, 11-20 minutes	62	48	$175.00	$74.28
99443 Telephone medical discussion with physician, 21-30 minutes	48	35	$250.00	$105.39
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	14	12	$145.00	$59.07
G0008 Administration of influenza virus vaccine	11	11	$38.00	$31.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	228	142	$199.99	$110.17
99213 Established patient office or other outpatient visit, typically 15 minutes	164	121	$143.94	$81.24
36415 Insertion of needle into vein for collection of blood sample	160	96	$20.00	$3.00
80053 Blood test, comprehensive group of blood chemicals	141	88	$55.00	$10.31
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	141	90	$40.00	$7.59
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	121	91	$270.58	$153.74
83735 Magnesium level	53	34	$34.00	$6.17
83540 Iron level	27	25	$33.00	$6.27
83550 Iron binding capacity	27	25	$45.00	$8.47
82728 Ferritin (blood protein) level	23	22	$70.00	$13.63
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	23	13	$33.00	$6.47
85007 Microscopic examination for white blood cells with manual cell count	23	13	$18.00	$3.80
82607 Cyanocobalamin (vitamin B-12) level	23	23	$77.00	$15.08
84100 Phosphate level	22	16	$25.00	$3.84
82746 Folic acid level	21	21	$77.00	$14.70
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	14	$92.63	$51.00
99442 Telephone medical discussion with physician, 11-20 minutes	15	12	$158.20	$78.69
82378 Carcinoembryonic antigen (cea) protein level	13	12	$97.00	$16.51
G0008 Administration of influenza virus vaccine	13	13	$38.00	$17.98
90662 Influenza vaccine split virus, preservative free	11	11	$110.00	$65.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0129 Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	2,000	15	$81.00	$56.52
J0897 Injection, denosumab, 1 mg	1,980	11	$27.00	$20.01
36415 Insertion of needle into vein for collection of blood sample	302	106	$20.00	$2.98
99213 Established patient office or other outpatient visit, typically 15 minutes	241	117	$157.00	$68.52
80053 Blood test, comprehensive group of blood chemicals	232	89	$55.00	$10.48
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	213	91	$40.00	$7.73
96413 Infusion of chemotherapy into a vein up to 1 hour	106	59	$380.00	$130.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	99	70	$229.00	$96.40
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	70	22	$33.00	$6.40
96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less	69	33	$201.00	$65.86
83735 Magnesium level	68	36	$34.00	$6.66
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	48	26	$62.00	$13.02
84153 Psa (prostate specific antigen) measurement, total	46	11	$94.00	$18.30
83540 Iron level	46	36	$33.00	$6.44
83550 Iron binding capacity	46	36	$45.00	$8.70
82728 Ferritin (blood protein) level	44	37	$70.00	$13.57
85007 Microscopic examination for white blood cells with manual cell count	41	16	$18.00	$3.77
84100 Phosphate level	33	16	$25.00	$4.72
96375 Injection of additional new drug or substance into vein	33	17	$54.00	$14.96
96415 Administration of chemotherapy into vein, each additional hour	31	14	$95.00	$27.71
82607 Cyanocobalamin (vitamin B-12) level	31	28	$77.00	$15.02
82746 Folic acid level	29	26	$77.00	$14.64
99231 Follow-up hospital inpatient care per day, typically 15 minutes	24	21	$83.00	$36.04
96374 Injection of drug or substance into a vein for therapy, diagnosis, or prevention	23	11	$138.00	$36.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	16	$94.00	$41.89
J1200 Injection, diphenhydramine hcl, up to 50 mg	17	13	$2.00	$0.75
84443 Blood test, thyroid stimulating hormone (TSH)	16	11	$86.00	$16.78
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	13	$307.00	$134.23

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q0138 Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)	13,770	17	$2.00	$0.93
J1453 Injection, fosaprepitant, 1 mg	7,050	28	$3.00	$2.02
J9263 Injection, oxaliplatin, 0.5 mg	6,400	12	$30.00	$0.16
J0129 Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	2,725	16	$81.00	$52.28
J0897 Injection, denosumab, 1 mg	2,520	13	$27.00	$18.64
J1745 Injection, infliximab, excludes biosimilar, 10 mg	1,430	12	$149.00	$67.34
J1100 Injection, dexamethasone sodium phosphate, 1 mg	596	29	$1.00	$0.12
J2469 Injection, palonosetron hcl, 25 mcg	440	27	$142.00	$11.79
J9190 Injection, fluorouracil, 500 mg	214	13	$8.00	$1.75
36415 Insertion of needle into vein for collection of blood sample	211	91	$20.00	$2.94
96375 Injection of additional new drug or substance into vein	201	57	$54.00	$15.16
96413 Infusion of chemotherapy into a vein up to 1 hour	188	95	$380.00	$128.76
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	175	81	$40.00	$8.46
J3475 Injection, magnesium sulfate, per 500 mg	156	21	$3.00	$0.65
J3480 Injection, potassium chloride, per 2 meq	155	11	$1.00	$0.16
99213 Established patient office or other outpatient visit, typically 15 minutes	146	95	$157.00	$66.83
96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less	143	75	$201.00	$63.68
80053 Blood test, comprehensive group of blood chemicals	136	70	$55.00	$11.51
J1335 Injection, ertapenem sodium, 500 mg	109	20	$70.00	$46.70
96415 Administration of chemotherapy into vein, each additional hour	107	41	$95.00	$27.76
96367 Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less	107	32	$95.00	$28.40
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg	59	16	$15.00	$4.01
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	57	28	$62.00	$15.06
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	49	$229.00	$98.10
J1200 Injection, diphenhydramine hcl, up to 50 mg	56	30	$2.00	$0.74
96374 Injection of drug or substance into a vein for therapy, diagnosis, or prevention	50	20	$138.00	$35.51
96417 Administration of additional new drug or substance into vein, 1 hour or less	49	25	$189.00	$62.19
96366 Infusion into a vein for therapy, prevention, or diagnosis, each additional hour	47	20	$70.00	$19.56
83550 Iron binding capacity	33	22	$45.00	$9.52
83540 Iron level	33	22	$33.00	$7.05
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	31	17	$33.00	$7.04
83735 Magnesium level	31	21	$34.00	$7.29
82728 Ferritin (blood protein) level	30	22	$70.00	$14.85
J2505 Injection, pegfilgrastim, 6 mg	26	14	$8000.00	$4497.70
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	26	21	$94.00	$40.88
96377 Application of on-body injector for under skin injection	26	14	$71.00	$18.29
J7030 Infusion, normal saline solution , 1000 cc	25	16	$23.00	$2.45
96411 Administration of additional new drug or substance into vein using push technique	25	13	$167.00	$53.34
96523 Irrigation of implanted venous access drug delivery device	19	13	$67.00	$24.11
82607 Cyanocobalamin (vitamin B-12) level	18	14	$77.00	$16.41
96416 Administration of prolonged chemotherapy into vein	18	12	$408.00	$129.00
82746 Folic acid level	17	13	$77.00	$16.01
96360 Infusion into a vein for hydration, 31-60 minutes	17	12	$156.00	$34.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q0138 Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)	14,280	16	$2.00	$0.94
J1453 Injection, fosaprepitant, 1 mg	10,350	33	$3.00	$2.06
J0129 Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	3,950	14	$81.00	$50.03
J0897 Injection, denosumab, 1 mg	3,420	13	$27.00	$17.91
J1100 Injection, dexamethasone sodium phosphate, 1 mg	1,068	39	$1.00	$0.12
J2469 Injection, palonosetron hcl, 25 mcg	690	33	$142.00	$19.15
96375 Injection of additional new drug or substance into vein	284	60	$54.00	$16.03
36415 Insertion of needle into vein for collection of blood sample	270	71	$20.00	$2.94
96413 Infusion of chemotherapy into a vein up to 1 hour	248	90	$380.00	$125.03
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	240	73	$40.00	$9.40
80053 Blood test, comprehensive group of blood chemicals	194	58	$55.00	$12.78
99213 Established patient office or other outpatient visit, typically 15 minutes	193	79	$157.00	$65.15
J9310 Injection, rituximab, 100 mg	169	16	$1248.00	$796.66
96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less	154	59	$201.00	$64.15
96415 Administration of chemotherapy into vein, each additional hour	138	43	$95.00	$27.05
96367 Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less	138	38	$95.00	$27.98
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	119	36	$62.00	$18.33
J3475 Injection, magnesium sulfate, per 500 mg	102	14	$3.00	$0.61
96366 Infusion into a vein for therapy, prevention, or diagnosis, each additional hour	77	19	$70.00	$19.57
96417 Administration of additional new drug or substance into vein, 1 hour or less	74	29	$189.00	$61.53
J1200 Injection, diphenhydramine hcl, up to 50 mg	65	34	$2.00	$0.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	27	$94.00	$39.36
96360 Infusion into a vein for hydration, 31-60 minutes	45	15	$156.00	$41.94
J7030 Infusion, normal saline solution , 1000 cc	44	16	$23.00	$2.48
83735 Magnesium level	37	12	$34.00	$8.10
83540 Iron level	31	20	$33.00	$7.83
83550 Iron binding capacity	31	20	$45.00	$10.57
96523 Irrigation of implanted venous access drug delivery device	29	11	$67.00	$25.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	23	$229.00	$93.44
82728 Ferritin (blood protein) level	24	17	$70.00	$16.49
J2505 Injection, pegfilgrastim, 6 mg	20	16	$8000.00	$4517.92
96377 Application of on-body injector for under skin injection	16	13	$71.00	$18.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q0138 Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)	16,320	16	$2.00	$0.88
J1453 Injection, fosaprepitant, 1 mg	5,550	15	$3.00	$1.92
J1568 Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	3,076	11	$78.00	$34.80
J1745 Injection, infliximab, excludes biosimilar, 10 mg	2,535	12	$149.00	$84.21
J0897 Injection, denosumab, 1 mg	1,980	19	$27.00	$16.78
J1100 Injection, dexamethasone sodium phosphate, 1 mg	984	27	$1.00	$0.12
J2469 Injection, palonosetron hcl, 25 mcg	430	19	$142.00	$21.57
36415 Insertion of needle into vein for collection of blood sample	369	153	$20.00	$2.94
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	307	135	$40.00	$10.45
80053 Blood test, comprehensive group of blood chemicals	281	132	$55.00	$13.75
99213 Established patient office or other outpatient visit, typically 15 minutes	235	119	$157.00	$65.21
96413 Infusion of chemotherapy into a vein up to 1 hour	208	62	$380.00	$122.59
J9310 Injection, rituximab, 100 mg	207	13	$1248.00	$786.09
96367 Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less	199	45	$95.00	$27.55
96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less	161	55	$201.00	$61.65
96415 Administration of chemotherapy into vein, each additional hour	154	34	$95.00	$24.97
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	86	39	$62.00	$22.74
96366 Infusion into a vein for therapy, prevention, or diagnosis, each additional hour	82	15	$70.00	$16.60
J3489 Injection, zoledronic acid, 1 mg	77	12	$416.00	$13.49
J1200 Injection, diphenhydramine hcl, up to 50 mg	67	27	$2.00	$0.63
96375 Injection of additional new drug or substance into vein	52	22	$54.00	$19.76
83735 Magnesium level	51	22	$34.00	$9.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	29	$229.00	$94.67
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	41	31	$94.00	$39.01
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	40	26	$33.00	$8.69
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	39	11	$5.00	$2.93
82728 Ferritin (blood protein) level	38	33	$70.00	$18.33
83550 Iron binding capacity	37	32	$45.00	$11.75
83540 Iron level	37	32	$33.00	$8.70
85007 Microscopic examination for white blood cells with manual cell count	34	22	$18.00	$4.62
96417 Administration of additional new drug or substance into vein, 1 hour or less	27	11	$189.00	$58.65
J7030 Infusion, normal saline solution , 1000 cc	23	11	$23.00	$2.00
82378 Carcinoembryonic antigen (cea) protein level	21	15	$97.00	$25.49
96360 Infusion into a vein for hydration, 31-60 minutes	20	12	$156.00	$51.89
J2505 Injection, pegfilgrastim, 6 mg	18	11	$8000.00	$4157.89

Medical Specialties & State Licenses

CMS Verified: 2024-03-12

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IL 085.003590

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Northwestern Medical Faculty Foundation

1 Kish Hospital Dr, Dekalb, IL 601159602

Phone: 8157667334

Northwestern Medical Faculty Foundation

660 N Westmoreland Rd, Lake Forest, IL 600451673

Phone: 3129266146

Northwestern Medical Faculty Foundation

515 Valley View Dr, Moline, IL 612656175

Phone: 3126950870

Northwestern Medical Faculty Foundation

675 N Saint Clair St, Chicago, IL 606115975

Northwestern Medical Faculty Foundation

5 Kish Hospital Dr, Dekalb, IL 601159602

Northwestern Medical Faculty Foundation

675 N St Clair, Chicago, IL 606115975

Northwestern Medical Faculty Foundation

10 Health Services Dr, Dekalb, IL 601159637

Phone: 8157564722

Northwestern Medical Faculty Foundation

2635 Church Rd, Aurora, IL 605028943

Phone: 6303156900

Secondary Practice Locations

17495 South Lagrange Road

Tinley Park, IL 60487

Phone: 7082267000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners

Carrie Feid , APN, CNP

Nurse Practitioner

NPI 1093111957

Advanced Practice Nurse, Certified Nurse Practitioner

Alysia Moret-Schmerbach , APRN, CNP

Nurse Practitioner

NPI 1194562793

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Kristen Govig , APRN, CNP

Nurse Practitioner

NPI 1225992779

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Dr. Sohail Chaudhry , MD

Internal Medicine - Hematology & Oncology

NPI 1245247717

Doctor of Medicine (M.D.)

Amit Bhate

Radiology - Radiation Oncology

NPI 1255597167

Dr. Kanchi Patell , MD

Clinic/Center - Oncology

NPI 1538782511

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Practice Location July 06, 2021

Registered at 10 HEALTH SERVICES DR, DEKALB, IL 601159600 (Tel: 8157565255)

📍

Updated Business Mailing Address July 06, 2021

Registered at 10 HEALTH SERVICES DR, DEKALB, IL 601159600 (Tel: 8157565255)

✅

NPI Profile Active February 08, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location February 08, 2017

Registered at 17495 SOUTH LAGRANGE ROAD, TINLEY PARK, IL 60487 (Tel: 7082267000)

📍

Updated Business Mailing Address February 08, 2017

Registered at 17495 SOUTH LAGRANGE ROAD, TINLEY PARK, IL 60487 (Tel: 7082267000)

👤

Provider Name / Credentials Updated February 08, 2017

Recorded as HALEY GOULSON, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2017

Physician Assistant (License #085.003590 in IL)

✅

NPI Profile Active October 10, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location October 10, 2013

Registered at 1051 ESSINGTON RD, SUITE 290, JOLIET, IL 604352801 (Tel: 8157730099)

📍

Updated Business Mailing Address October 10, 2013

Registered at 1051 ESSINGTON RD, SUITE 290, JOLIET, IL 604352801 (Tel: 8157730099)

👤

Provider Name / Credentials Updated October 10, 2013

Recorded as HALEY GOULSON, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 10, 2013

Physician Assistant (License #085.003590 in IL)

🟢

Initial NPI Registration & Enumeration October 19, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417283938

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 19, 2009

Last Update: March 12, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

10 Health Services Dr

Dekalb, IL 601159600

Phone: 8157565255

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.