Individual provider Active NPI

Ema Dzaka-Dizdarevic, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1699020800
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036137646 Issued in IL
Practice address
Saint Joseph Hospital 2900 N. Lakeshore Drive
Chicago, IL 60657
Phone
(773) 665-3000
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036137646 IL Primary

Addresses

Primary practice location

Saint Joseph Hospital 2900 N. Lakeshore Drive
Chicago, IL 60657

Mailing address

Saint Joseph Hospital 2900 N. Lakeshore Drive
Chicago, IL 60657
Phone (773) 665-3000

Other practice location 1

2913 N Commonwealth Ave
Chicago, IL 60657-6211
Phone (773) 883-2800

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
I20160218000000 IL Practitioner - Internal Medicine 4385949015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presence Healthcare ServicesGroup PAC ID 2860396769, 69 clinicians

Practice addresses (Care Compare)

1525 W Belmont Ave
Suite 101
Chicago, IL 60657-7115
Phone (773) 883-2800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Healthcare Services Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Presence Healthcare Services Current Accepting new patients
Presence Healthcare Services CurrentSince Oct 1, 2016 Accepting new patients

Locations

1000 Remington Blvd
Ste 100
Bolingbrook, IL 60440
Phone (630) 914-2417

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

2913 N Commonwealth Ave
Fl 5
Chicago, IL 60657
Phone (773) 472-3427

2913 N Commonwealth Ave
Chicago, IL 60657
Phone (773) 665-3080

2800 N Sheridan Rd
Ste 60
Chicago, IL 60657
Phone (773) 525-8846

62311 Collection Ctr Dr
Chicago, IL 60693

1525 W Belmont Ave
Ste 101
Chicago, IL 60657
Phone (773) 883-2800

Interoperability endpoints

  • Direct secure messaging: ema.dzaka-dizdarevic.1@3547.direct.athenahealth.com

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 1

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1699020800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SAINT JOSEPH HOSPITAL 2900 N. LAKESHORE DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-665-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAINT JOSEPH HOSPITAL 2900 N. LAKESHORE DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-665-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2913 N Commonwealth Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606576211",
            "country_code": "US",
            "telephone_number": "773-883-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DZAKA-DIZDAREVIC",
        "first_name": "EMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036137646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.