Active NPI
Roman F Niziolek, M.D.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1396729554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036-067726
- Practice address
- 5025 N Paulina St
Chicago, IL 60640-2772 - Phone
- (773) 271-9040
- Fax
- (773) 989-1516
- NPI assigned
- Dec 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-067726 | IL | Primary |
| Emergency Medicine Physician | 207P00000X | 036067726 | IL |
Addresses
Primary practice location
5025 N Paulina St
Chicago, IL 60640-2772
Mailing address
603 W Nichols Rd
Arlington Heights, IL 60004-1321
Phone (224) 234-7642
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-067726 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thorek Radiology Group NFP | Current | Accepting new patients |
Locations
2741 Paysphere Cir
Chicago, IL 60674
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 and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1588261978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470873600000",
"number": "1396729554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 W NICHOLS RD",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600041321",
"telephone_number": "224-234-7642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5025 N PAULINA ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606402772",
"telephone_number": "773-271-9040",
"fax_number": "773-989-1516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIZIOLEK",
"first_name": "ROMAN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2016-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-067726",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036067726",
"primary": false
}
],
"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 Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.