Organization Active NPI

Comprehensive Pediatric Care

  • Pediatrics Physician
  • Arlington Heights, IL
National Provider Identifier
1568630234
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036118003 Issued in IL
Legal business name
COMPREHENSIVE PEDIATRIC CARE
Practice address
657 E. Golf Rd
Suite 309
Arlington Heights, IL 60005-4968
Phone
(224) 404-6000
Fax
(773) 774-0019
NPI assigned
Feb 15, 2008
Last updated
Oct 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Mariola Jackowski, M.DNPI 1295937662
Title
M.D
Phone
(224) 404-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036118003 IL Primary

Addresses

Primary practice location

657 E. Golf Rd
Suite 309
Arlington Heights, IL 60005-4968

Mailing address

657 E. Golf Rd
Suite 309
Arlington Heights, IL 60005-4968
Phone (224) 404-6000

Other identifiers 1

IdentifierTypeStateIssuer
036118003MedicaidIL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2118191Comprehensive Pediatric Care657 E Golf Rd, Ste 309, Arlington Heights, IL 60005Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

657 E Golf Rd
Ste 309
Arlington Hts, IL 60005
Phone (847) 871-5770

7447 W Talcott Ave
Ste 248
Chicago, IL 60631

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1568630234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E. GOLF RD",
            "address_2": "SUITE 309",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054968",
            "telephone_number": "224-404-6000",
            "fax_number": "773-774-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 E. GOLF RD",
            "address_2": "SUITE 309",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054968",
            "telephone_number": "224-404-6000",
            "fax_number": "773-774-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PEDIATRIC CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "JACKOWSKI",
        "authorized_official_first_name": "MARIOLA",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "224-404-6000",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036118003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036118003",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.