Individual provider Active NPI

Andrea Pawlak, APRN, FNP-BC

  • Nurse Practitioner
  • Hazel Crest, IL
National Provider Identifier
1053898130
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209017857 Issued in IL
Practice address
17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone
(708) 213-4200
NPI assigned
Jul 23, 2018
Last updated
May 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209017857 IL Primary

Addresses

Primary practice location

17800 Kedzie Ave
Hazel Crest, IL 60429-2029

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address apawlak214230@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 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
I20180905003609 IL Practitioner - Nurse Practitioner 9739439134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 684-5340

17850 Kedzie Ave
Suite 2200
Hazel Crest, IL 60429-2056
Phone (708) 873-8476

17850 S Kedzie Ave
Suite 2100
Hazel Crest, IL 60429-2056
Phone (708) 684-5630

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

4400 W 95TH St
Suite 306
Oak Lawn, IL 60453-2659
Phone (708) 684-5428

4440 W 95TH St
Oak Lawn, IL 60453-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Sep 8, 2018 Accepting new patients
Cermak Medical Group LLC CurrentSince Jun 7, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Sep 8, 2018 Accepting new patients
Mea Chicago PC Nurse Practitioner CurrentSince May 1, 2019 Accepting new patients

Locations

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

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

29373 Network Pl
Chicago, IL 60673

5741 W Cermak Rd
Cicero, IL 60804
Phone (708) 222-0100

17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200

4740 W 95th St
Oak Lawn, IL 60453
Phone (708) 425-4334

Interoperability endpoints

  • Direct secure messaging: apawlak214230@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.

Hospital & facility affiliations 4

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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1053898130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292029",
            "telephone_number": "708-213-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLAK",
        "first_name": "ANDREA",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apawlak214230@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "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": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

Verify at the official NPI Registry.