Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jackson Ross Smith, PA-C

Individual provider Physician Assistant · NPI 1598659963

Jackson Ross Smith, PA-C is a Physician Assistant in McHenry, Illinois. Qualified in 2025, 1 year ago. Practices with Dupage Emergency Physicians Convenient Care LLC, a 30-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2620 Arbor Dr
McHenry, IL 60050-2694
Phone: (815) 385-9877
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1236209

Record details

NPI number1598659963
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 9, 2025
Last updated in NPPESJune 18, 2025
Certification dateJune 18, 2025
Mailing address2620 Arbor Dr, McHenry, IL 60050-2694

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Dupage Emergency Physicians Convenient Care Llc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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