Individual provider Active NPI

Tom Blicharski, APN

  • Clinical Nurse Specialist
  • Oak Lawn, IL
National Provider Identifier
1033460381
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
209.009677 Issued in IL
Practice address
4701 W 102ND St
Oak Lawn, IL 60453-4223
Phone
(708) 738-1182
NPI assigned
Sep 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 209.009677 IL Primary

Addresses

Primary practice location

4701 W 102ND St
Oak Lawn, IL 60453-4223

Mailing address

4701 W 102ND St
Oak Lawn, IL 60453-4223
Phone (708) 738-1182

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180223000146 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 2062659055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J R Nephology and Associates IncGroup PAC ID 5496783334, 4 clinicians

Practice addresses (Care Compare)

4542 W 95TH St
Oak Lawn, IL 60453-2627
Phone (708) 425-0522

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
209.009677ILMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
J R Nephology & Associates Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

4542 W 95th St
Oak Lawn, IL 60453
Phone (219) 775-7722

Interoperability endpoints

  • Direct secure messaging: tblicharski347867@direct.myadvocateaurora.org

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1033460381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 W 102ND ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534223",
            "telephone_number": "708-738-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 W 102ND ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534223",
            "telephone_number": "708-738-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICHARSKI",
        "first_name": "TOM",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209.009677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.