Active NPI
Philip Nathaniel Jurasinski, DO
- Infectious Disease Physician
- Chicago, IL
National Provider Identifier
1205183688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 036.174274
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1443 - Phone
- (708) 751-2340
- NPI assigned
- Aug 5, 2012
- Last updated
- May 9, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2021040593 | MO | |
| Registered Nurse | 163W00000X | 179993-30 | WI | |
| Registered Nurse | 163W00000X | 2021033345 | MO | |
| Internal Medicine Physician | 207R00000X | 2021021932 | MO | |
| Internal Medicine Physician | 207R00000X | 036.174274 | IL | |
| Infectious Disease Physician | 207RI0200X | 036.174274 | IL | Primary |
| Pediatrics Physician | 208000000X | 036.174274 | IL | |
| Pediatrics Physician | 208000000X | 2021021932 | MO | |
| Pediatric Infectious Diseases Physician | 2080P0208X | 036.174274 | IL |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210716000772 | MO | Order and Referring Only - Internal Medicine | 1759783459 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021033345 | MO | MD | Registered Nurse |
| 179993-30 | WI | MD | Registered Nurse |
| 036.174274 | IL | MD | Internal Medicine Physician |
| 2021040593 | MO | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- pjurasinski411560@direct.saint-lukes.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1205183688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 HARVESTER DR STE 110",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276686",
"telephone_number": "773-702-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371443",
"telephone_number": "708-751-2340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURASINSKI",
"first_name": "PHILIP",
"middle_name": "NATHANIEL",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-05",
"last_updated": "2025-05-09",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MO",
"license": "2021040593",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "179993-30",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2021033345",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2021021932",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.174274",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "IL",
"license": "036.174274",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.174274",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2021021932",
"primary": false
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "IL",
"license": "036.174274",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.