Individual provider Active NPI

Mariusz Milejczyk, MD

  • Internal Medicine Physician
  • Libertyville, IL
National Provider Identifier
1467598235
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036093940 Issued in IL
Practice address
1880 W Winchester Rd Ste 106
Libertyville, IL 60048-5321
Phone
(847) 367-4277
Fax
(847) 810-0287
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036093940 IL Primary

Addresses

Primary practice location

1880 W Winchester Rd Ste 106
Libertyville, IL 60048-5321

Mailing address

15 Tower CRT 255
Gurnee, IL 60031
Phone (847) 623-8818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070619000177 IL Practitioner - Internal Medicine 0840399788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1880 W Winchester Rd
Suite 106
Libertyville, IL 60048-5321
Phone (847) 367-4277

Hospital & facility affiliations

  • Vita Health Care, Inc Home health agency, Northbrook, IL, CCN 148153
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Internal Medicine Associates, LLC Internal Medicine CurrentSince Jun 17, 2012 Accepting new patients
Lake County Internal Medicine Association LLC Past Accepting new patients

Locations

15 Tower Ct
Ste 255
Gurnee, IL 60031
Phone (847) 623-8818

15 Tower Ct
Ste 190
Gurnee, IL 60031
Phone (847) 263-8388

1880 W Winchester Rd
Ste 106
Libertyville, IL 60048
Phone (847) 672-4940

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1467598235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TOWER CRT 255",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "60031",
            "telephone_number": "847-623-8818",
            "fax_number": "847-625-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 W WINCHESTER RD STE 106",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485321",
            "telephone_number": "847-367-4277",
            "fax_number": "847-810-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILEJCZYK",
        "first_name": "MARIUSZ",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036093940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.