Individual provider Active NPI

Adam Edward Mikolajczyk, M.D.

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1275829798
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036.135065 Issued in IL
Practice address
1801 W Taylor St Ste 1B
Chicago, IL 60612-4795
Phone
(312) 996-7598
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036.135065 IL Primary
Internal Medicine Physician 207R00000X 125.059372 IL

Addresses

Primary practice location

1801 W Taylor St Ste 1B
Chicago, IL 60612-4795

Mailing address

840 S Wood St
Chicago, IL 60612-4325
Phone (312) 996-6292

Other practice location 1

180 Harvester Dr
Suite 110
Burr Ridge, IL 60527-7594
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141018000247 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 1153554498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Chicago, Pritzker School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

840 S Wood St MC
787 Uic Medicine
Chicago, IL 60612-4325
Phone (312) 413-8687

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.059372ILMDInternal Medicine Physician
036.135065ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 28, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Aug 28, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Locations

835 S Wolcott Ave
Rm W140
Chicago, IL 60612

1801 W Taylor St
Ste 1B
Chicago, IL 60612
Phone (312) 996-7598

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

7732 Solutions Ctr
Chicago, IL 60677

840 S Wood St
Chicago, IL 60612
Phone (312) 996-6711

840 S Wood St
#787
Chicago, IL 60612
Phone (312) 413-8687

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: amikolajczyk17302@uihealth.direct-ci.com

Organizations & group practices 5

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 1

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1275829798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST STE 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-996-7598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Harvester Dr",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "605277594",
            "country_code": "US",
            "telephone_number": "773-702-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKOLAJCZYK",
        "first_name": "ADAM",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.135065",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.059372",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.