NPIMap

Individual provider Active NPI

Jozef J Rzucidlo, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1194829408
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036 097266 Issued in IL
Practice address
5857 S Archer Ave Unit B
Chicago, IL 60638-1619
Phone
(708) 496-8400
Fax
(708) 496-8416
NPI assigned
Sep 8, 2006
Last updated
Dec 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036 097266 IL Primary

Addresses

Primary practice location

5857 S Archer Ave Unit B
Chicago, IL 60638-1619

Mailing address

5857 S Archer Ave Unit B
Chicago, IL 60638-1619
Phone (708) 496-8400

Other identifiers 1

IdentifierTypeStateIssuer
036-066225MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ Direct
Direct Messaging Address jrzucidlo276219@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080905000582 IL Practitioner - Family Practice 5193891638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5857 S Archer Ave
Unit B
Chicago, IL 60638-1619
Phone (708) 496-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036 097266ILMDFamily Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDGIAA/Endpoint/EDGIAA
  • Direct secure messaging: jrzucidlo276219@direct.myadvocateaurora.org

Organizations & group practices 1

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1194829408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5857 S ARCHER AVE UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381619",
            "telephone_number": "708-496-8400",
            "fax_number": "708-496-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5857 S ARCHER AVE UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381619",
            "telephone_number": "708-496-8400",
            "fax_number": "708-496-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RZUCIDLO",
        "first_name": "JOZEF",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036 097266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-066225",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5857 S Archer Ave Unit B",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606381619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrzucidlo276219@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5857 S Archer Ave Unit B",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606381619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.