Organization Active NPI

Eugenia Grochowska MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1396007456
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EUGENIA GROCHOWSKA MD
Practice address
5647 W Lawrence Ave
Chicago, IL 60630-3219
Phone
(773) 545-5252
Fax
(773) 545-5671
NPI assigned
Jun 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Authorized official

Name
Eugenia Grochowska, M.D.NPI 1154302297
Title
Owner
Phone
(773) 545-5252

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5647 W Lawrence Ave
Chicago, IL 60630-3219

Mailing address

5647 W Lawrence Ave
Chicago, IL 60630-3219
Phone (773) 545-5252

Other identifiers 2

IdentifierTypeStateIssuer
036062717MedicaidIL
21609795OtherILBLUE CROSS BLUE SHIELD OF ILLINOIS

Other names 1

  • Eugenia Grochowska MD Doing business as

National Provider Directory

National Provider Directory

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": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1396007456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5647 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303219",
            "telephone_number": "773-545-5252",
            "fax_number": "773-545-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5647 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303219",
            "telephone_number": "773-545-5252",
            "fax_number": "773-545-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENIA GROCHOWSKA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "GROCHOWSKA",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-545-5252",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062717",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ILLINOIS",
            "identifier": "21609795",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eugenia Grochowska MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.