Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaclyn L Mis, PAC

Individual provider Physician Assistant · NPI 1073899548

Jaclyn L Mis, PAC is a Physician Assistant in Tinley Park, Illinois. Qualified in 2011, 15 years ago. Practices with Dupage Medical Group Ltd, a 1,328-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
15
Licensed in
IL
In the registry since
2011
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone: (815) 416-6641
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2320 High St, Blue Island, IL 60406-2426 — (708) 388-5500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085004190 (IL)

Record details

NPI number1073899548
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 28, 2011
Last updated in NPPESJuly 24, 2023
Certification dateJuly 24, 2023
Mailing addressPo Box 713260, Chicago, IL 60677-1260

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Dupage Medical Group Ltd — 1328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Tinley Park