Jared Evan Bukowski, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125.084281 Issued in IL

Practice address

1775 Ballard Rd FL 2
Park Ridge, IL 60068-1005

Phone

(847) 318-6020

Fax

(847) 318-2341

NPI assigned

Mar 25, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  NPD (past)

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1639929656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W DEMPSTER ST FL 2",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 BALLARD RD FL 2",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681005",
            "telephone_number": "847-318-6020",
            "fax_number": "847-318-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKOWSKI",
        "first_name": "JARED",
        "middle_name": "EVAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.084281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shams Bakhos Bufalino, M.D.
• Bryan Bugay, LCPC
• Building Blocks Group, Inc.
• Malgorzata Aleksandra Bujarska, MD
• Sarosh Bukhari, D.O.
• Rachel Bukowski, DNP, FNP-C
• Milena Bulic
• Katherine Bulthuis
• Brady Hunter Bunkelman, MS, CGC
• Liliana Burdea

• Family Medicine Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.