Organization Active NPI

Debra L. Jaryszak, M.D., LLC

  • Obstetrics & Gynecology Physician
  • Elgin, IL
National Provider Identifier
1225068117
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
DEBRA L. JARYSZAK, M.D., LLC
Practice address
1975 Lin Lor LN
Suite 195
Elgin, IL 60123-4902
Phone
(847) 531-8800
Fax
(847) 531-8680
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Debra L Jaryszak, M.D.NPI 1659434579
Title
President
Phone
(847) 531-8800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X IL Primary

Addresses

Primary practice location

1975 Lin Lor LN
Suite 195
Elgin, IL 60123-4902

Mailing address

1975 Lin Lor LN
Suite 195
Elgin, IL 60123-4902
Phone (847) 531-8800

Other identifiers 1

IdentifierTypeStateIssuer
04532167OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

1975 Lin Lor Ln
Ste 195
Elgin, IL 60123
Phone (847) 468-1511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225068117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 LIN LOR LN",
            "address_2": "SUITE 195",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234902",
            "telephone_number": "847-531-8800",
            "fax_number": "847-531-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 LIN LOR LN",
            "address_2": "SUITE 195",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234902",
            "telephone_number": "847-531-8800",
            "fax_number": "847-531-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA L. JARYSZAK, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JARYSZAK",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-531-8800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04532167",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.