Jeffrey K Zawacki, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036-089882 Issued in IL

Practice address

3245 Grove Ave
Suite 202
Berwyn, IL 60402-3474

Phone

(708) 484-0621

Fax

(708) 484-0250

NPI assigned

Oct 20, 2005

Sex

Male

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

General SurgeryAlso: Colorectal Surgery (Proctology)

Education

University of Massachusetts Medical School, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Macneal Hospital Hospital, Berwyn, IL, CCN 140054
• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CAHHBD
• Direct secure messaging: jzawacki105022@direct.luhs.org

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.

• Loyola Medical Group LLC

  • General Practice Physician
  • Berwyn, IL
  • NPI 1376041954
  Medicare reassignment Care Compare group NPD
• Suburban Surgical Associates, LTD

  • Surgery Physician
  • Hinsdale, IL
  • NPI 1821088667
  Medicare reassignment NPD Authorized official
• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment NPD
• Loyola University Medical Center

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Suburban Metabolic Institute, LLC

  • Specialist
  • Hinsdale, IL
  • NPI 1659690022
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gottlieb Community Health Services Corporation

  • General Acute Care Hospital
  • Berwyn, IL
  • NPI 1295710580
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1790774750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE",
            "address_2": "SUITE 202",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023474",
            "telephone_number": "708-484-0621",
            "fax_number": "708-484-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE",
            "address_2": "SUITE 202",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023474",
            "telephone_number": "708-484-0621",
            "fax_number": "708-484-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAWACKI",
        "first_name": "JEFFREY",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-089882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089882",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP NUMBER",
            "identifier": "01619787",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mustafa Zakaria, PA-C
• Urvi Zala
• Edith Zamudio
• Irene Zamudio, MSW
• Iridian Zaragoza, RN
• George Randall Zehak, D.D.S.
• Jennifer Zendol Carr, SLP/L
• Xin Zhang, DO
• Richard W Ziegler, D.D.S.
• Angela Sue Zinzer, LCSW

• Surgery Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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.