Individual provider Active NPI

Jerzy Szymanski, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1679509046
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036085357 Issued in IL
Practice address
5257 S Cicero Ave
Chicago, IL 60632-4915
Phone
(773) 735-8038
Fax
(773) 735-8297
NPI assigned
Jun 25, 2006
Last updated
May 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036085357 IL Primary

Addresses

Primary practice location

5257 S Cicero Ave
Chicago, IL 60632-4915

Mailing address

5257 S Cicero Ave
Chicago, IL 60632-4915
Phone (773) 735-8038

Other names 1

  • Dr. Jerry Szymanski Professional 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
I20110826000505 IL Practitioner - Family Practice 4183693179 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036085357ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nowobilska Medical Practice LTD CurrentSince Jun 7, 2011 Accepting new patients
MD Family Medical Practice LLC PastSince May 16, 2021 Accepting new patients

Locations

5257 S Cicero Ave
Chicago, IL 60632
Phone (773) 735-8038

4201 W 95th St
Oak Lawn, IL 60453
Phone (708) 636-1466

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1679509046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324915",
            "telephone_number": "773-735-8038",
            "fax_number": "773-735-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5257 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324915",
            "telephone_number": "773-735-8038",
            "fax_number": "773-735-8297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZYMANSKI",
        "first_name": "JERZY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036085357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "SZYMANSKI",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.