Individual provider Active NPI

Thomas B Pawlowski, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1093867921
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-061042 Issued in IL
Practice address
2003 W Fulton St Ste 3
Chicago, IL 60612-2365
Phone
(773) 342-6200
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-061042 IL Primary

Addresses

Primary practice location

2003 W Fulton St Ste 3
Chicago, IL 60612-2365

Mailing address

2003 W Fulton St Ste 3
Chicago, IL 60612-2365
Phone (773) 292-4800

Other identifiers 1

IdentifierTypeStateIssuer
36-061042OtherILLIC PHY AND SURGEON

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100327000380 IL Practitioner - Family Practice 8123154283 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-061042ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgecare, Inc. CurrentSince Oct 5, 2018 Accepting new patients
Healing Hands Physicians, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Home Physicians PC Past Accepting new patients

Locations

1645 S River Rd
Ste 2
Des Plaines, IL 60018
Phone (224) 803-2273

1305 Remington Rd
Ste M
Schaumburg, IL 60173
Phone (224) 938-9264

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1093867921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST STE 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122365",
            "telephone_number": "773-292-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST STE 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122365",
            "telephone_number": "773-342-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLOWSKI",
        "first_name": "THOMAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-061042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC PHY AND SURGEON",
            "identifier": "36-061042",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.