Individual provider Active NPI

Pavel Polinovsky, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1083900195
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004046 Issued in IL
Practice address
3000 N Halsted St Ste 625
Chicago, IL 60657-5196
Phone
(773) 296-6666
NPI assigned
Jun 27, 2011
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004046 IL Primary
Surgical Physician Assistant 363AS0400X 085004046 IL

Addresses

Primary practice location

3000 N Halsted St Ste 625
Chicago, IL 60657-5196

Mailing address

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

Other practice location 1

675 N St Clair St
Ste 20-100 Galter Pavilion
Chicago, IL 60611
Phone (312) 695-1920

Other identifiers 2

IdentifierTypeStateIssuer
F400187717OtherILMEDICARE PTAN (INDIVIDUAL)
206147OtherILMEDICARE PTAN (GROUP)

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ppolinovsky460132@direct.myadvocateaurora.org Direct
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
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
I20110920000308 IL Practitioner - Physician Assistant 6800067091 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 Commerce Dr
Oak Brook, IL 60523-8865

1135 S Delano CT E
Chicago, IL 60605-3457
Phone (630) 933-1500

1135 W Delano CT
A201
Chicago, IL 60605-3457
Phone (312) 695-0665

1333 W Belmont Ave
Chicago, IL 60657-5785

1630 Sherman Ave
Evanston, IL 60201-3711

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 998-9910

4445 W Irving Park Rd
Chicago, IL 60641-2808

4732 N Lincoln Ave
Chicago, IL 60625-8561
Phone (847) 475-2273

635 N Dearborn St
Chicago, IL 60654-4618
Phone (312) 926-0404

635 N Fairbanks CT
FL 1
Chicago, IL 60611-5435
Phone (312) 472-3173

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 23, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 23, 2017 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Rush University Medical Center Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 20100
Chicago, IL 60611
Phone (312) 695-1920

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 6

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 1

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1083900195",
    "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": "3000 N HALSTED ST STE 625",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "773-296-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 N St Clair St",
            "address_2": "Ste 20-100 Galter Pavilion",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-695-1920",
            "fax_number": "312-695-5747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLINOVSKY",
        "first_name": "PAVEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004046",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085004046",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400187717",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppolinovsky460132@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3000 N Halsted St Ste 625",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "address_2": "SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "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": "3000 N Halsted St Ste 625",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.