Jeffrey Bzdusek, DO
Individual provider Active NPI Emergency Medicine Physician · Blue Island, IL
NPI 1144266016 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144266016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Practice address
- 12935 Gregory St
Blue Island, IL 60406-2428 - Phone
- (708) 597-2000
- Fax
- (708) 824-4494
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Mid West Medical College, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iems Physician Services PLLC
Practice addresses (Care Compare)
326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-3900
Hospital & facility affiliations
- St Bernard Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060301000619 | IL | Practitioner - Emergency Medicine | 1759397615 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036113573 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation for Emergency Services | Current |
Accepting new patients | |
| Foundation for Emergency Services | Emergency Medicine | Current | Accepting new patients |
| Illinois/Indiana Em-I Medical Services, S.C. | Emergency Medicine | Past | Accepting new patients |
Locations
326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900
Interoperability endpoints
- jbzdusek@direct-address.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | IL | Yes |
Addresses
Primary practice location
12935 Gregory St
Blue Island, IL 60406-2428
Mailing address
5100 N Marine Dr
Chicago, IL 60640-3274
Other providers in Blue Island, IL
- Rita Brongiel
- Melissa R Brousil
- Gina Brown
- Frank M Bucki Jr.
- Darlene Jo Buis
- Marina Cajas
- Brenda Carbajal
- Loretta Carpenter
- Natalie Renee Casey
- Julliana Castaneda
All providers in Blue Island, IL · Emergency Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.