Individual provider Active NPI

Tipbhrapa Jaojaroenkul, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1174748735
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
1634 W Polk St
Chicago, IL 60612-4352
Phone
(312) 829-4224
Fax
(312) 829-3742
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

1634 W Polk St
Chicago, IL 60612-4352

Mailing address

3538 Riverside Dr
Wilmette, IL 60091-1050
Phone (847) 251-1568

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
I20121002000139 IL Order and Referring Only - Family PracticePractitioner - Family Practice 9335398627

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-058247ILMDSpecialist
036058247ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174748735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3538 RIVERSIDE DR",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911050",
            "telephone_number": "847-251-1568",
            "fax_number": "847-251-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124352",
            "telephone_number": "312-829-4224",
            "fax_number": "312-829-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAOJAROENKUL",
        "first_name": "TIPBHRAPA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.