Individual provider Active NPI

Jennifer Marie Orozco, PA-C

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1396715017
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
85-002136 Issued in IL
Practice address
1725 W Harrison St
Suite#1156
Chicago, IL 60612-3841
Phone
(312) 563-2109
Fax
(312) 563-4388
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 85-002136 IL Primary

Addresses

Primary practice location

1725 W Harrison St
Suite#1156
Chicago, IL 60612-3841

Mailing address

600 S Paulina St
761 Aac
Chicago, IL 60612-3806
Phone (312) 942-5407

Other names 1

  • Jennifer Marie Frederick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
85-002136ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince May 15, 2006 Accepting new patients
North Shore Cosmetic Surgery & Wellness Center LTD PastSince Jan 1, 2008 Accepting new patients
Rush University Medical Center Past Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 115
Chicago, IL 60612
Phone (312) 829-2540

75 Remittance Dr
Ste 16
Chicago, IL 60675

1725 W Harrison St
Ste 1156
Chicago, IL 60612
Phone (312) 563-2762

Interoperability endpoints

  • Direct secure messaging: jorozco2853@direct.rush.rush-health.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1396715017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST",
            "address_2": "761 AAC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-5407",
            "fax_number": "312-563-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE#1156",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-563-2109",
            "fax_number": "312-563-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OROZCO",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "85-002136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FREDERICK",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 19, 2013; 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.