Individual provider Active NPI

Robert Stanislaw Budziakowski, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1508075102
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036119835 Issued in IL
Practice address
3115 N Harlem Ave
Suite 201
Chicago, IL 60634-4684
Phone
(773) 889-0355
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036119835 IL Primary

Addresses

Primary practice location

3115 N Harlem Ave
Suite 201
Chicago, IL 60634-4684

Mailing address

720 N Broadway Ave
Park Ridge, IL 60068-2312

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
I20080929000670 IL Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 9032286331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3115 N Harlem Ave
Suite 201
Chicago, IL 60634-4683
Phone (773) 889-0355

Hospital & facility affiliations

  • Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036119835ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Budziakowski, MD, S.C. Family Medicine CurrentSince Aug 1, 2009 Accepting new patients

Locations

3115 N Harlem Ave
Ste 201
Chicago, IL 60634
Phone (773) 792-1011

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1508075102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N BROADWAY AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 N HARLEM AVE",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344684",
            "telephone_number": "773-889-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDZIAKOWSKI",
        "first_name": "ROBERT",
        "middle_name": "STANISLAW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036119835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.