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

Individual provider Physician Assistant · NPI 1144865601

Jaclyn F. Koziol, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2019, 7 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group and accepts Medicare assignment. Licensed in Illinois and Indiana.

Years since qualifying
7
Licensed in
IL, IN
In the registry since
2019
Specialties on file
2
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

211 E Ontario St Ste 200
Chicago, IL 60611-3284
Phone: (312) 694-7000
Fax: (312) 926-6274
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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 085008587 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 10002865A (IN)

Record details

NPI number1144865601
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 8, 2019
Last updated in NPPESMay 23, 2022
Certification dateMay 23, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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