Individual provider Active NPI

Marion G Jelcz, M.D.

  • Obstetrics & Gynecology Physician
  • Skokie, IL
National Provider Identifier
1720070170
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036082775 Issued in IL
Practice address
4905 Old Orchard Ctr Ste 200
Skokie, IL 60077-1462
Phone
(847) 869-5800
Fax
(847) 869-9315
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036082775 IL Primary

Addresses

Primary practice location

4905 Old Orchard Ctr Ste 200
Skokie, IL 60077-1462

Mailing address

2801 Lakeside Dr Ste 209
Bannockburn, IL 60015-1271
Phone (847) 562-1410

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
I20071017000497 IL Practitioner - Obstetrics/Gynecology 1052212305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Center for Women'S Healthcare, LTDGroup PAC ID 7012818354, 93 clinicians

Practice addresses (Care Compare)

135 N Arlington Heights Rd
Suite 101
Buffalo Grove, IL 60089-8214
Phone (847) 537-5200

250 Ctr Dr
Suite 101
Vernon Hills, IL 60061-1582
Phone (847) 918-7050

350 S Northwest Hwy
Park Ridge, IL 60068-4262
Phone (847) 825-8108

4709 Golf Rd
Suite 320 325
Skokie, IL 60076-1231
Phone (847) 499-2648

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036082775ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Center for Women'S Healthcare Obstetrics & Gynecology Past Accepting new patients
Midwest Center for Women'S Healthcare Obstetrics & Gynecology PastSince Oct 15, 2007 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21117/brand/1/csg/1/fhir/r4
  • Direct secure messaging: marion.jelcz.1@21117.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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1720070170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 LAKESIDE DR STE 209",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151271",
            "telephone_number": "847-562-1410",
            "fax_number": "847-562-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR STE 200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771462",
            "telephone_number": "847-869-5800",
            "fax_number": "847-869-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELCZ",
        "first_name": "MARION",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036082775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.