Stefan Parker Czestochowski, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036149141 Issued in IL

Practice address

1740 W Taylor St
Chicago, IL 60612-7232

Phone

(866) 600-2273

NPI assigned

Apr 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sczestochowski765377@direct.ochin.org
• FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4

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.

• Erie Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1760499545
  Medicare reassignment NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1124187125
  Medicare reassignment NPD
• Erie Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1548062318
  NPD
• Erie Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1407043912
  NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1477812030
  NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1659127199
  NPD

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

{
    "created_epoch": "1461369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1700230034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-584-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 S California Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606322016",
            "country_code": "US",
            "telephone_number": "773-584-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CZESTOCHOWSKI",
        "first_name": "STEFAN",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-23",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036149141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stefan.czestochowski.1@11903.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4700 S California Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606322016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Czekaj, PHARMD, RPH
• Charles Stanley Czerepak, D.M.D.
• Agnes M Czernik
• Jonah Czerwinskyj
• Jolanta Czerwonka
• Peter Czobor, M.D.
• Christine Czochara
• Megan Elizabeth Czosek, P.A.-C.
• Emily Kathleen Czuba, PT, DPT
• Michael Czuma, OD

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.