Child, Adolescent, & Adult Psychiatry SC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036091684 Issued in IL

Legal business name

CHILD, ADOLESCENT, & ADULT PSYCHIATRY SC

Practice address

5420 N Milwaukee Ave
Chicago, IL 60630

Phone

(773) 594-9944

Fax

(773) 594-9944

NPI assigned

May 29, 2008

Organization subpart

Yes

Parent organization

CHILD ADOLESCENT & ADULT PSYCHIATRY SCAs reported in NPPES

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

Authorized official

Name

Mr. Slawomir Jan Puszkarski, M.D.NPI 1679606560

Title

Psychiatrist

Phone

(773) 594-9944

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Slawomir Jan Puszkarski & Lucyna Maria Puszkarska Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Part of

Child Adolescent Adul

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Slawomir Jan Puszkarski, MD

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1679606560
  Medicare reassignment Care Compare group Authorized official
• Lucyna Puszkarska, M.D.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1215035902
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1568620326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60630",
            "telephone_number": "773-594-9944",
            "fax_number": "773-594-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60630",
            "telephone_number": "773-594-9944",
            "fax_number": "773-594-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD, ADOLESCENT, & ADULT PSYCHIATRY SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILD ADOLESCENT & ADULT PSYCHIATRY SC",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "PUSZKARSKI",
        "authorized_official_first_name": "SLAWOMIR",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "773-594-9944",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036091684",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036093737",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-091684",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Slawomir Jan Puszkarski & Lucyna Maria Puszkarska",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Child & Adolescent Health Assoc LTD
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• Child Family Center for Health Wellbeing LTD
• Child Link Inc
• Child Study Center
• Carol Lynn Childers, M.D.
• Sara Childers, MD
• Children and Families First
• Children and Families Support Services P.C.
• Children'S Dental World, LLC

• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.