Organization Active NPI

Schaumburg Medical Center PC

  • Internal Medicine Physician
  • Schaumburg, IL
National Provider Identifier
1316163249
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SCHAUMBURG MEDICAL CENTER PC
Practice address
1144 S Roselle Rd
Schaumburg, IL 60193-4072
Phone
(847) 524-3200
Fax
(847) 524-3300
NPI assigned
Apr 18, 2007
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
Dr. Jaroslaw K Drag, M.D.NPI 1609936954
Title
Doctor
Phone
(847) 524-3200

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

1144 S Roselle Rd
Schaumburg, IL 60193-4072

Mailing address

1144 S Roselle Rd
Schaumburg, IL 60193-4072
Phone (847) 524-3200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080714000510 IL Part B Supplier - Clinic/Group Practice 7719050442 Receives reassigned benefits from 1 practitioner
Practice locations: Schaumburg, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0972481Schaumburg Medical Center1144 S Roselle Road, Schaumburg, IL 60193Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory

Locations

1144 S Roselle Rd
Schaumburg, IL 60193
Phone (847) 524-3200

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": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316163249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 S ROSELLE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601934072",
            "telephone_number": "847-524-3200",
            "fax_number": "847-524-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 S ROSELLE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601934072",
            "telephone_number": "847-524-3200",
            "fax_number": "847-524-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHAUMBURG MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRAG",
        "authorized_official_first_name": "JAROSLAW",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "847-524-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.