Alicja B Poleszak, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-100964 Issued in IL

Practice address

7740 W North Ave
Elmwood Park, IL 60707-4124

Phone

(708) 456-3200

Fax

(708) 456-3427

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alicja Barbara Poleszak S.C.

  • Family Medicine Physician
  • Elmwood Park, IL
  • NPI 1073792545
  Medicare reassignment NPD Authorized official
• West Suburban Hospital Medical Center

  • Skilled Nursing Facility
  • Oak Park, IL
  • NPI 1538206974
  NPD (past)
• West Suburban Medical Center

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1649499096
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1699729020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 W NORTH AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074124",
            "telephone_number": "708-456-3200",
            "fax_number": "708-456-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 W NORTH AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074124",
            "telephone_number": "708-456-3200",
            "fax_number": "708-456-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLESZAK",
        "first_name": "ALICJA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-100964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1634704",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100964",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Pepek, PHARMD
• Matthew David Phillips, MD
• Physiotherapy Associates Inc
• Seema Pillai, NP
• Cynthia Plazas, PH.D., LCPC
• Anthony Orlando Ponzio, D.D.S
• PPD North Avenue LLC
• Presence Ambulatory Services
• Presence Ambulatory Services
• Proactive Health Care

• Family Medicine Physician in Elmwood Park, IL
• Providers in Elmwood Park, 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 Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.