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

Jacob Edward Johnson

Individual provider Critical Care Medicine Nurse Practitioner · NPI 1750278040

Jacob Edward Johnson is a Nurse Practitioner in Park Ridge, Illinois. Qualified in 2024, 2 years ago. Practices with Advocate Health and Hospitals Corporation, a 3,079-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2025

Practice location Address checks out

1775 Dempster St
Park Ridge, IL 60068-1143
Phone: (847) 723-2210
Show map & directions

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

Specialties & licences

Critical Care Medicine Nurse Practitioner (primary) Taxonomy 363LC0200X · Licence 209-032261 (IL)

Record details

NPI number1750278040
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 20, 2025
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025
Mailing address29373 Network Pl, Chicago, IL 60673-1293

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Advocate Health And Hospitals Corporation — 3079 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Park Ridge