Stanislav I Pavlovsky, MD PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036098316 Issued in IL

Practice address

1401 W Dundee Rd
Suite 202
Buffalo Grove, IL 60089-4055

Phone

(847) 818-7700

Fax

(847) 818-1718

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Personal Doctor Olga Zarkh MD LTD

  • Multi-Specialty Clinic/Center
  • Buffalo Grove, IL
  • NPI 1356544944
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1003996299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W DUNDEE RD",
            "address_2": "SUITE 202",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894055",
            "telephone_number": "847-818-7700",
            "fax_number": "847-818-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W DUNDEE RD",
            "address_2": "SUITE 202",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894055",
            "telephone_number": "847-818-7700",
            "fax_number": "847-818-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOVSKY",
        "first_name": "STANISLAV",
        "middle_name": "I",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036098316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098316",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0021623087",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shreya V. Patel, O.D.
• Pathways Pediatric Therapy Inc
• Pathways Therapy, PLLC
• Antoinette Paul
• Debra Paust, PTA
• Iga Aleksandra Pawlus
• Pdi Medical III LLC
• Boris Peck, D.D.S.
• Jane Pedersen, ED.D.
• Pediatric & Adolescent Center, S.C.

• Psychiatry Physician in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.