Pawel S Dudek, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036096327 Issued in IL

Practice address

4250 N Marine Dr
Suite 236
Chicago, IL 60613-1744

Phone

(773) 404-0160

Fax

(773) 404-9876

NPI assigned

Apr 1, 2006

Last updated

Jun 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Pawel S Dudek Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Pawel S. Dudek, M.D., S.C.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1306056734
  Authorized official Same address or phone
• Institute for Personal Development

  • Psychiatry Physician
  • Morris, IL
  • NPI 1942247895
  NPD (past)

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1043271554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407860",
            "telephone_number": "773-654-1645",
            "fax_number": "773-681-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 N MARINE DR",
            "address_2": "SUITE 236",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131744",
            "telephone_number": "773-404-0160",
            "fax_number": "773-404-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "PAWEL",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-01",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036096327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096327",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "404206",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "180759",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "415428",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2017926",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "01635497",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY",
            "identifier": "401806",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAWEL",
            "last_name": "DUDEK",
            "middle_name": "S",
            "credential": "M.D., S.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Felicia Anne Dudek, MS LCPC CADC
• Janusz Dudek, MD
• Joanna Dudek, DPT
• Marta A Dudek, M.D.
• Mary Dudek, P.A.
• Renata Maria Dudek, COTA/L, OTR/L, OTD
• Walter John Dudek Jr., DDS
• Rosaria Marie Dudgeon, OT
• Brian Dudley, RN
• Emily Dudley, AU.D.

• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.