Individual provider Active NPI

Maria Karbowska-Jankowska

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
National Provider Identifier
1184722647
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036-089658 Issued in IL
Practice address
100 NE Randolph Ave
Peoria, IL 61606-1919
Phone
(309) 624-8500
Fax
(309) 624-8552
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036-089658 IL
Physical Medicine & Rehabilitation Physician 208100000X 036-089658 IL Primary

Addresses

Primary practice location

100 NE Randolph Ave
Peoria, IL 61606-1919

Mailing address

100 NE Randolph Ave
Peoria, IL 61606-1919
Phone (309) 624-8500

Other identifiers 1

IdentifierTypeStateIssuer
036089658MedicaidIL

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
I20100723000460 IL Practitioner - Physical Medicine and RehabilitationPractitioner - Neurology 7911039193

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Neurology
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 NE Glen Oak Ave Cbo
Peoria, IL 61603-3200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-089658ILMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1184722647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE RANDOLPH AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061919",
            "telephone_number": "309-624-8500",
            "fax_number": "309-624-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE RANDOLPH AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061919",
            "telephone_number": "309-624-8500",
            "fax_number": "309-624-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARBOWSKA-JANKOWSKA",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-089658",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-089658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089658",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.