Individual provider Active NPI

Janice Ruth R. Klich, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Park Ridge, IL
National Provider Identifier
1053312561
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
036058059 Issued in IL
Practice address
1600 W Dempster St
Suite 120
Park Ridge, IL 60068-1109
Phone
(847) 635-9006
Fax
(847) 635-8360
NPI assigned
Aug 9, 2005
Last updated
Jun 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036-058059 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 76082 WI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036058059 IL Primary

Addresses

Primary practice location

1600 W Dempster St
Suite 120
Park Ridge, IL 60068-1109

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

Other practice location 1

9555 S 52nd Ave
Oak Lawn, IL 60453-3054
Phone (708) 634-0950

Other practice location 2

14555 W National Ave
New Berlin, WI 53151-4494
Phone (844) 284-0381

Other identifiers 1

IdentifierTypeStateIssuer
100325824MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jklich205400@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250625000034 WI Practitioner - Critical Care (Intensivists) 0143251660 Reassigns benefits to 1 organization
I20250625000062 IL Practitioner - Critical Care (Intensivists) 0143251660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-058059ILMDCritical Care Medicine (Internal Medicine) Physician
76082WIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince May 17, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 17, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 1, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince May 1, 2025 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9555 S 52nd Ave
Oak Lawn, IL 60453
Phone (708) 422-5700

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

14555 W National Ave
Ste 140
New Berlin, WI 53151
Phone (262) 827-0480

Interoperability endpoints

  • Direct secure messaging: jklich20098@cghmc.direct-ci.com
  • Direct secure messaging: jklich205400@direct.myadvocateaurora.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1053312561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-874-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W DEMPSTER ST",
            "address_2": "SUITE 120",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681109",
            "telephone_number": "847-635-9006",
            "fax_number": "847-635-8360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9555 S 52nd Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533054",
            "country_code": "US",
            "telephone_number": "708-634-0950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14555 W National Ave",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531514494",
            "country_code": "US",
            "telephone_number": "844-284-0381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLICH",
        "first_name": "JANICE RUTH",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036-058059",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WI",
            "license": "76082",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036058059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100325824",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jklich205400@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.