Active NPI
Libby Pollack, PA-C
- Physician Assistant
- Chicago, IL
National Provider Identifier
1396148730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085005147
- Practice address
- 2835 N Sheffield Ave Ste 303
Chicago, IL 60657-5084 - Phone
- (773) 368-3164
- NPI assigned
- Sep 30, 2014
- Last updated
- Sep 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085005147 | IL | Primary |
Addresses
Primary practice location
2835 N Sheffield Ave Ste 303
Chicago, IL 60657-5084
Mailing address
833 W Roscoe St Apt 2W
Chicago, IL 60657-2556
Phone (847) 293-5422
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2835 N Sheffield Ave
Suite 303
Chicago, IL 60657-5084
Phone (773) 368-3164
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085005147 | IL | MD | Physician Assistant |
Interoperability endpoints
- lpollack282005@direct.myadvocateaurora.org
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.
-
- Gastroenterology Physician
- Chicago, IL
- NPI 1548414063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412035200000",
"number": "1396148730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 W ROSCOE ST APT 2W",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606572556",
"telephone_number": "847-293-5422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 N SHEFFIELD AVE STE 303",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575084",
"telephone_number": "773-368-3164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLACK",
"first_name": "LIBBY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-30",
"last_updated": "2014-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085005147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.