Lukasz J Sidorowicz

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

238.000043 Issued in IL

Practice address

3249 Oak Park Ave
Berwyn, IL 60402-3429

Phone

(773) 502-4221

Fax

(773) 404-2086

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Enterprise Surgical Assistance

  • Surgical Physician Assistant
  • Berwyn, IL
  • NPI 1992910988
  NPD (past)
• Northern Illinois Emergency Surgical Serv LTD

  • Surgical Critical Care Physician
  • Evanston, IL
  • NPI 1861589020
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1124236971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56341",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606560341",
            "telephone_number": "708-867-4949",
            "fax_number": "708-867-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "773-502-4221",
            "fax_number": "773-404-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOROWICZ",
        "first_name": "LUKASZ",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238.000043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF IL",
            "identifier": "01637103",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven James Sharp, M.D.
• Candice Sherlock, RDH
• Dawn Sherwood, L.S.W.
• Sherry Shibu, DO
• Lemin Kimmy Shimada, CRNA
• Maya Siegel
• Ana Elizabeth Sierra, MA
• Angel Sifuentes, LSW
• Muna Sigdel
• Benjamin J. Sigwarth, PA-C

• Surgical Physician Assistant in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.