Individual provider Active NPI

Jeffrey Kenneth Rosenwinkel, MD

  • Family Medicine Physician
  • Lakemoor, IL
National Provider Identifier
1215466222
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036171070 Issued in IL
Practice address
27655 Illinois Route 120
Lakemoor, IL 60051
Phone
(815) 458-1500
Fax
(815) 458-1501
NPI assigned
Jun 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01084381A IN
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 036171070 IL Primary

Addresses

Primary practice location

27655 Illinois Route 120
Lakemoor, IL 60051

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-5000

Other identifiers 1

IdentifierTypeStateIssuer
300040921MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address jrosenwinkel402295@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200813000304 IN Practitioner - Family Practice 2062782683 Reassigns benefits to 2 organizations
I20240808003106 IL Practitioner - Family Practice 2062782683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036171070ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc CurrentSince Aug 30, 2020 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Current Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Saint Joseph Regional Medical Center, Inc. Family Medicine CurrentSince Aug 30, 2020 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Aug 30, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 15, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 15, 2024 Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Family Medicine Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

27655 W State Route 120
Lakemoor, IL 60051
Phone (630) 368-1776

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

611 E Douglas Rd
Ste 137
Mishawaka, IN 46545
Phone (574) 335-6214

60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500

611 E Douglas Rd
Ste 407
Mishawaka, IN 46545
Phone (574) 335-6500

510 W Adams St
Ste 150
Plymouth, IN 46563
Phone (574) 335-3987

1122 S Ironwood Dr
South Bend, IN 46615
Phone (574) 335-8399

707 Cedar St
Ste 405
South Bend, IN 46617

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

Interoperability endpoints

  • Direct secure messaging: jrosenwinkel402295@direct.myadvocateaurora.org

Organizations & group practices 9

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

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1215466222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27655 ILLINOIS ROUTE 120",
            "city": "LAKEMOOR",
            "state": "IL",
            "postal_code": "60051",
            "telephone_number": "815-458-1500",
            "fax_number": "815-458-1501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5215 Holy Cross Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465451469",
            "country_code": "US",
            "telephone_number": "574-335-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENWINKEL",
        "first_name": "JEFFREY",
        "middle_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2024-08-02",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01084381A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036171070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300040921",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "27655 Illinois Route 120",
            "city": "Lakemoor",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrosenwinkel402295@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "27655 Illinois Route 120",
            "city": "Lakemoor",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakemoor, IL

Sources for this page

Verify at the official NPI Registry.