Active NPI
Marion G Jelcz, M.D.
- Obstetrics & Gynecology Physician
- Skokie, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036082775
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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, LTD
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036082775 | IL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Center for Women'S Healthcare | Obstetrics & Gynecology | Past | Accepting new patients |
| Midwest Center for Women'S Healthcare | Obstetrics & Gynecology | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/21117/brand/1/csg/1/fhir/r4
- 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.
-
- Obstetrics & Gynecology Physician
- Bannockburn, IL
- NPI 1447200654
IL
-
- Obstetrics & Gynecology Physician
- Evanston, IL
- NPI 1477673085
Obstetrics & Gynecology
-
- Obstetrics & Gynecology Physician
- Evanston, IL
- NPI 1689971665
Obstetrics & Gynecology
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.
- 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.