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Jeremy Daniel Golon

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1725 W Harrison St Ste 970, Chicago, IL 60612-3828

PECOS Enrollment

This provider is enrolled in PECOS as JEREMY GOLON.

Based on the most recent information from CMS, provider Jeremy Daniel Golon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1437865680
Provider Type
Individual
Full Name
Golon, Jeremy Daniel
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
1/30/2023
Last Updated
1/30/2023

Contact Information

Practice Location

1725 W Harrison St Ste 970, Chicago, IL 60612-3828

(414) 630-7410

Unlisted Fax

Mailing Location

11203 W Abbott Ave, Hales Corners, WI 53130-1211

(414) 630-7410

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer Wisconsin
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer Illinois
Code 363AS0400X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer Wisconsin

Jeremy Daniel Golon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Casalino, Dana

Roy, Anne Heller

Freeman, Bethann

Vlaming, Jessica K

Rao, Prerana

Scott, Elizabeth

Zaparaniuk, Natalia Maria

Rogowski, Wendy Ann

Barnes, Brenda L

Han, Michael Peter