NPIMap

Individual provider Active NPI

Jacek Zajac, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Lombard, IL
National Provider Identifier
1396817912
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
361-07774 Issued in IL
Practice address
2500 S Highland Ave
Ste 104
Lombard, IL 60148-5381
Phone
(630) 629-3610
Fax
(630) 629-4878
NPI assigned
Nov 15, 2006
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 361-07774 IL Primary

Addresses

Primary practice location

2500 S Highland Ave
Ste 104
Lombard, IL 60148-5381

Mailing address

2500 S Highland Ave
Ste 104
Lombard, IL 60148-5381
Phone (630) 629-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051215000606 IL Practitioner - Endocrinology 7618998873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endocrinology Associates SCGroup PAC ID 5193746352, 2 clinicians

Practice addresses (Care Compare)

2500 S Highland Ave
Suite 104
Lombard, IL 60148-5381
Phone (630) 629-3610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
361-07774ILMDEndocrinology, Diabetes & Metabolism Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHCJBA/Endpoint/BHCJBA
  • Direct secure messaging: jzajac251155@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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1396817912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S HIGHLAND AVE",
            "address_2": "STE 104",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485381",
            "telephone_number": "630-629-3610",
            "fax_number": "630-629-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S HIGHLAND AVE",
            "address_2": "STE 104",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485381",
            "telephone_number": "630-629-3610",
            "fax_number": "630-629-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "JACEK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "361-07774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.