Jefferson Park Medical Group, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JEFFERSON PARK MEDICAL GROUP, P.C.

Practice address

5906 N Milwaukee Ave
Chicago, IL 60646-5420

Phone

(773) 774-7300

Fax

(773) 774-7313

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Richard Ansfield

Title

Director

Phone

(773) 774-7300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Locations

Practitioners 10

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

• Cynthia A Carlson, RD,LDN

  • Registered Dietitian
  • Oak Lawn, IL
  • NPI 1477818748

  IL

  Medicare reassignment Care Compare group NPD
• Robert Kaplan, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1073561460

  Family Medicine, IL

  Medicare reassignment Care Compare group NPD
• Rosalia Maria Lomeli, FNP

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1891497152

  IL

  Medicare reassignment Care Compare group NPD
• Scott Tyrrell, DO

  • Student in an Organized Health Care Education/Training Program
  • La Grange, IL
  • NPI 1831833235

  IL

  Medicare reassignment Care Compare group NPD
• John David Mason, PA-C

  • Physician Assistant
  • Danville, IL
  • NPI 1811949118

  IL

  Medicare reassignment Care Compare group
• Riaz A Akhtar, MD

  • Cardiovascular Disease Physician
  • Oak Brook Terrace, IL
  • NPI 1407877160

  IL

  Medicare reassignment NPD
• Ronke' Alisha Battie, APN

  • Family Nurse Practitioner
  • Rockford, IL
  • NPI 1437871928

  IL

  Medicare reassignment NPD
• Mohamed Boshnaf

  • Internal Medicine Physician
  • North Little Rock, AR
  • NPI 1811575145

  IL

  Medicare reassignment NPD
• Higgins Durand

  • Physician Assistant
  • Skokie, IL
  • NPI 1285266007

  IL

  Medicare reassignment
• April C Leddell-Hughes, D.P.M.

  • Podiatrist
  • Chesterton, IN
  • NPI 1619011376

  IN

  Medicare reassignment

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366490047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5906 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465420",
            "telephone_number": "773-774-7300",
            "fax_number": "773-774-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5906 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465420",
            "telephone_number": "773-774-7300",
            "fax_number": "773-774-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON PARK MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANSFIELD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-774-7300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "01630200",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Starzyk Jeffe, MD
• Jefferson Park Counseling
• Jefferson Park Family Dental LLC
• Jefferson Park Medical Center
• Jefferson Park Medical Center, LTD.
• Tanya Jefferson-Fitts
• Serena Jefferson-Jackson
• Deborah Bishop Jefferson, APN-CNP
• Faith Jefferson
• Janelle Jefferson, L.AC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• 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.