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

Shannon Johnson, PA

Individual provider Physician Assistant · NPI 1811675317

Shannon Johnson, PA is a Physician Assistant in Glen Ellyn, Illinois. Qualified in 2024, 2 years ago. Practices with Dupage Medical Group Ltd, a 1,328-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2023
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

430 Pennsylvania Ave Ste 240
Glen Ellyn, IL 60137-4464
Phone: (630) 790-1872
Fax: (630) 545-7850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10900 Euclid Ave, Cleveland, OH 44106-1712 — (216) 368-0575

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-010958 (IL)

Record details

NPI number1811675317
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 6, 2023
Last updated in NPPESApril 25, 2025
Certification dateApril 25, 2025
Mailing addressPob 7132960, Chicago, IL 60677-0001

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Dupage Medical Group Ltd — 1328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Glen Ellyn