Individual provider Active NPI

George Tomecki, M.D.

  • Family Medicine Physician
  • Brookfield, IL
National Provider Identifier
1306972112
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-111748 Issued in IL
Practice address
8905 Burlington Ave
Brookfield, IL 60513
Phone
(708) 387-7000
Fax
(708) 387-7001
NPI assigned
Feb 26, 2007
Last updated
Jun 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-111748 IL Primary

Addresses

Primary practice location

8905 Burlington Ave
Brookfield, IL 60513

Mailing address

8905 Burlington Ave
Brookfield, IL 60513
Phone (708) 387-7000

Other identifiers 1

IdentifierTypeStateIssuer
0001635291OtherILBLUE CROSS BLUE SHIELD

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
I20050502000086 IL Practitioner - Family Practice 6800835679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8905 Burlington Ave
Brookfield, IL 60513-2034
Phone (708) 387-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111748ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Doctors of Brookfield SC CurrentSince Jul 1, 2005 Accepting new patients

Locations

8905 Burlington Ave
Brookfield, IL 60513
Phone (708) 387-7000

Organizations & group practices 1

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

Hospital & facility affiliations 6

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1306972112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8905 BURLINGTON AVE",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "60513",
            "telephone_number": "708-387-7000",
            "fax_number": "708-387-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 BURLINGTON AVE",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "60513",
            "telephone_number": "708-387-7000",
            "fax_number": "708-387-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMECKI",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-111748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001635291",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, IL

Sources for this page

Verify at the official NPI Registry.