Active NPI
Andrzej P. Indyk, M.D.S.C.
- Family Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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, 2025
- Organization subpart
- No
NPPES NPI Registry
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.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036089367 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Medicine Physician
- Chicago, IL
- NPI 1023065984
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.