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

Jacob Dalton Boehm, PA-C

Individual provider Physician Assistant · NPI 1932741717

Jacob Dalton Boehm, PA-C is a Physician Assistant in St Charles, Illinois. Qualified in 2019, 7 years ago. Practices with Physicians Immediate Care North Chicago LLC, a 261-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
7
Licensed in
IL
In the registry since
2019
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

409 Illinois Ave Unit 1D
St Charles, IL 60174-2966
Phone: (630) 974-6602
Fax: (630) 487-2411
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1200 W State St, Rockford, IL 61102-2112 — (815) 490-1600

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.007272 (IL)
Physician Assistant Taxonomy 363A00000X (IL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 085.007272 (IL)

Record details

NPI number1932741717
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 12, 2019
Last updated in NPPESNovember 22, 2024
Certification dateNovember 22, 2024

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 Physicians Immediate Care North Chicago Llc — 261 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in St Charles