Evan Tkaczyk, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

2322 W Peterson Ave.
Chicago, IL 60659-3120

Phone

(800) 325-1812

NPI assigned

Apr 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

93.41 of 100Reported as group

Quality

86.81

Improvement activities

40

Cost

77.34

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1134644164
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612051200000",
    "number": "1790305704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 S 2ND AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "630-408-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 W PETERSON AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593120",
            "telephone_number": "800-325-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACZYK",
        "first_name": "EVAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Yuwono Tjota, MD, PHD
• TK Physical Therapy and Sports Performance PLLC
• Igor Tkachenko, MD
• Mariah Tkachenko, LMT
• Joanna Tkacz, AGENT
• Stephanie Samantha Tkaczyk, OTR/L
• Sylvia Tkalitch, PT
• Tkoz Holdings LLC
• TLC Clinical, PLLC
• Kaoutar Tlemcani, M.D.

• Medical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2021; 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.