Active NPI
Joseph Aloysius Janicki, MD
- Pediatric Orthopaedic Surgery Physician
- Chicago, IL
National Provider Identifier
1427260959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Orthopaedic Surgery Physician
- License
- 036.118217
- Practice address
- 225 E Chicago Ave
Box #69
Chicago, IL 60611-2991 - Phone
- (312) 227-6190
- Fax
- (312) 227-9404
- NPI assigned
- May 4, 2007
- Last updated
- Mar 19, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | 036.118217 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Box #69
Chicago, IL 60611-2991
Mailing address
225 E Chicago Ave
Box #69
Chicago, IL 60611-2991
Phone (312) 227-6190
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1627123 | Other | IL | BCBS PROVIDER ID |
| 036118217 | Medicaid | IL |
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 |
|---|---|---|---|
| 036.118217 | IL | MD | Pediatric Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Lurie Children's Medical Group, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395187200000",
"number": "1427260959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"address_2": "BOX #69",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-6190",
"fax_number": "312-227-9404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"address_2": "BOX #69",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-6190",
"fax_number": "312-227-9404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANICKI",
"first_name": "JOSEPH",
"middle_name": "ALOYSIUS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2014-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "207XP3100X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
"state": "IL",
"license": "036.118217",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "1627123",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036118217",
"state": "IL"
}
],
"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 Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.