Individual provider Active NPI

Nicole Tomczuk, DO

  • Internal Medicine Physician
  • Deerfield, IL
National Provider Identifier
1649920588
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036176438 Issued in IL
Practice address
350 S Waukegan Rd Ste 200
Deerfield, IL 60015-5239
Phone
(847) 535-7157
Fax
(224) 271-4332
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036176438 IL Primary

Addresses

Primary practice location

350 S Waukegan Rd Ste 200
Deerfield, IL 60015-5239

Mailing address

350 S Waukegan Rd # 200
Deerfield, IL 60015-5239
Phone (847) 535-7157

Other names 1

  • Nicole Jamandron Santos Former name

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
I20250917002074 IL Practitioner - Internal Medicine 4284138884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

350 S Waukegan
Suite 150
Deerfield, IL 60015-5239
Phone (312) 926-3107

350 S Waukegan Rd
Deerfield, IL 60015-5239
Phone (312) 926-6146

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036176438ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

350 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 350-7297

350 S Waukegan Rd
#200
Deerfield, IL 60015

350 S Waukegan Rd
Ste 100
Deerfield, IL 60015
Phone (847) 926-0106

350 S Waukegan Rd
Ste 100200
Deerfield, IL 60015
Phone (312) 695-4525

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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 2

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1649920588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S WAUKEGAN RD # 200",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155239",
            "telephone_number": "847-535-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S WAUKEGAN RD STE 200",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155239",
            "telephone_number": "847-535-7157",
            "fax_number": "224-271-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCZUK",
        "first_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036176438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SANTOS",
            "middle_name": "JAMANDRON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Deerfield, IL

Sources for this page

Verify at the official NPI Registry.