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

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Practice location Address checks out

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

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients33
Services billed 151 a service is one billed item, such as a visit, a test or a procedure
Average patient age70

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Physicians Immediate Care North Chicago LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 261 clinicians in the practice; 12 are shown here.

Other providers in St Charles