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

Individual provider Physician Assistant · NPI 1003891649

John Louis Ancona, PA is a Physician Assistant in Oak Lawn, Illinois. Qualified in 1993, 33 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
33
Licensed in
IL
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4400 W 95th St Ste 205
Oak Lawn, IL 60453-2654
Phone: (630) 977-9764
Fax: (708) 346-3287
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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 085000886 (IL)

Record details

NPI number1003891649
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 7, 2005
Last updated in NPPESAugust 19, 2015
Mailing address4400 W 95th St, Suite 205, Oak Lawn, IL 60453-2654

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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