Individual provider Active NPI

Jadwiga Samulak, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1497926018
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
6121 N Elston
Chicago, IL 60646
Phone
(773) 792-0232
Fax
(773) 775-8541
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

6121 N Elston
Chicago, IL 60646

Mailing address

6121 N Elston
Chicago, IL 60646
Phone (773) 729-0232

Other names 1

  • Jadwiga Swarzynska Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019022535ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1497926018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 N ELSTON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60646",
            "telephone_number": "773-729-0232",
            "fax_number": "773-775-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 N ELSTON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60646",
            "telephone_number": "773-792-0232",
            "fax_number": "773-775-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMULAK",
        "first_name": "JADWIGA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADWIGA",
            "last_name": "SWARZYNSKA",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.