Jennifer Jedrzejczak

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

071010198 Issued in IL

Practice address

1650 Moon Lake Blvd
Hoffman Estates, IL 60169-1010

Phone

(847) 755-8579

NPI assigned

Dec 9, 2019

Last updated

Jul 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.63 of 100Reported as apm

Quality

88.47

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment Care Compare group NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1093352080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 BELMONT LN",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601038958",
            "telephone_number": "630-390-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MOON LAKE BLVD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691010",
            "telephone_number": "847-755-8579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10350 Haligus Rd Ste 200D",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429545",
            "country_code": "US",
            "telephone_number": "815-334-5018",
            "fax_number": "847-669-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEDRZEJCZAK",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "IL",
            "license": "071010198",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071010198",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010198",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James W. Sislow D.D.S. LTD.
• Tracy James
• Januario P. Estrada, M.D., S.C.
• Edith Jaucian, LCSW
• Jayashree R. Raju, D.O., P.C.
• Jeena Jacob Inc.
• Sandeep S Jejurikar, MD
• Simon Thomas Jencius, LCPC
• Jenna Gaw, DDS, PLLC
• Jenna Gaw, DDS, PLLC

• Health Psychologist in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Health Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.