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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063109627

Jacob Tyler Pike, PA-C is a Student in an Organized Health Care Education/Training Program in Evanston, Illinois. Works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2023
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

2650 Ridge Ave
Evanston, IL 60201-1700
Phone: (847) 525-7451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 29681 N Waukegan Rd Apt 204, Lake Bluff, IL 60044-5482 — (847) 525-7451

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085009824 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1063109627
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 24, 2023
Last updated in NPPESAugust 29, 2023
Certification dateAugust 29, 2023

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