Organization Active NPI

Andrzej P. Indyk, M.D.S.C.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1801827845
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ANDRZEJ P. INDYK, M.D.S.C.
Practice address
4920 N Central Ave
Suite 2a
Chicago, IL 60630-2338
Phone
(773) 202-8034
Fax
(773) 202-8147
NPI assigned
Jul 6, 2006
Last updated
Mar 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Dr. Andrzej P Indyk, M.D.NPI 1023065984
Title
Medical Director
Phone
(773) 202-8034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4920 N Central Ave
Suite 2a
Chicago, IL 60630-2338

Mailing address

4920 N Central Ave
Suite 2a
Chicago, IL 60630-2338
Phone (773) 202-8034

Other identifiers 1

IdentifierTypeStateIssuer
036089367MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060710000149 IL Part B Supplier - Clinic/Group Practice 5890708093 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

4742 N Austin Ave
Chicago, IL 60630
Phone (847) 870-3600

4920 N Central Ave
Ste 2A
Chicago, IL 60630
Phone (773) 202-8034

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1801827845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 N CENTRAL AVE",
            "address_2": "SUITE 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302338",
            "telephone_number": "773-202-8034",
            "fax_number": "773-202-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 N CENTRAL AVE",
            "address_2": "SUITE 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302338",
            "telephone_number": "773-202-8034",
            "fax_number": "773-202-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRZEJ P. INDYK, M.D.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "INDYK",
        "authorized_official_first_name": "ANDRZEJ",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-202-8034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089367",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.