Individual provider Active NPI

Jessica M Marganski

  • Family Nurse Practitioner
  • Palos Park, IL
National Provider Identifier
1619661063
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.027599 Issued in IL
Practice address
13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508
Phone
(708) 274-3278
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.027599 IL Primary

Addresses

Primary practice location

13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508

Mailing address

13011 S 104TH Ave
Palos Park, IL 60464-1506
Phone (708) 274-3278

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714003220 IL Practitioner - Nurse Practitioner 1658731120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Care Centers of Illinois, S.C.Group PAC ID 6103738810, 37 clinicians

Practice addresses (Care Compare)

13011 S 104TH Ave
Suite 100
Palos Park, IL 60464-1508
Phone (708) 274-3278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.027599ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Care Centers of Illinois, SC CurrentSince Jul 1, 2023 Accepting new patients
Heart Care Centers of Illinois, SC PastSince Jun 11, 2023 Accepting new patients

Locations

3231 Euclid Ave
Ste 400
Berwyn, IL 60402
Phone (708) 478-3600

2338 New St
Blue Island, IL 60406
Phone (708) 577-5060

11560 S Kedzie Ave
Ste 100
Merrionette Park, IL 60803
Phone (708) 824-1114

11560 S Kedzie Ave
Ste 102
Merrionette Park, IL 60803
Phone (708) 972-7520

13011 S 104th Ave
Palos Park, IL 60464
Phone (708) 274-3278

13011 S 104th Ave
Ste 100
Palos Park, IL 60464
Phone (708) 274-3278

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.

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1619661063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641506",
            "telephone_number": "708-274-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE STE 100",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641508",
            "telephone_number": "708-274-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGANSKI",
        "first_name": "JESSICA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

Verify at the official NPI Registry.