Jeffery John Kamysz, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036.083315 Issued in IL

Practice address

621 S Roselle Rd
2ND Floor
Schaumburg, IL 60193-3175

Phone

(312) 420-8414

NPI assigned

Jul 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1447457585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5514 W ARDMORE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466506",
            "telephone_number": "847-477-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S ROSELLE RD",
            "address_2": "2ND FLOOR",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933175",
            "telephone_number": "312-420-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMYSZ",
        "first_name": "JEFFERY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036-083315",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036083315",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.083315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abhinav Reddy Kakuturu, DO
• Alena Janine Kalamaris, D.C.
• Monica Kalinowski, D.D.S
• Kelly Kaminski
• Claire S Kaminsky, LCSW
• Andrea Chiyoung Kang, O.D.
• Taekyoung Kang, P.T
• Julianna Kania
• Olivia Ann Kania
• Alan Marc Kanter, M.D.

• General Practice Physician in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.