Active NPI
Jennifer Lynne Matczak
- Pediatrics Physician
- Barrington, IL
National Provider Identifier
1235386236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036.128871
- Practice address
- 450 W Highway 22
Medical Staff Office
Barrington, IL 60010-1919 - Phone
- (847) 381-9600
- NPI assigned
- Aug 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036.128871 | IL | Primary |
Addresses
Primary practice location
450 W Highway 22
Medical Staff Office
Barrington, IL 60010-1919
Mailing address
415 Anthony St
Glen Ellyn, IL 60137-4419
Phone (312) 371-2540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.128871 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1235386236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 ANTHONY ST",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601374419",
"telephone_number": "312-371-2540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 W HIGHWAY 22",
"address_2": "MEDICAL STAFF OFFICE",
"city": "BARRINGTON",
"state": "IL",
"postal_code": "600101919",
"telephone_number": "847-381-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATCZAK",
"first_name": "JENNIFER",
"middle_name": "LYNNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.128871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barrington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.