Active NPI
Joanna Pozdal
- Family Medicine Physician
- Elk Grove Village, IL
National Provider Identifier
1821029323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 36114785
- Practice address
- 800 Biesterfield Rd
Wimmer Suite 204
Elk Grove Village, IL 60007-3361 - Phone
- (630) 453-8819
- Fax
- (630) 348-6248
- NPI assigned
- Jul 5, 2006
- Last updated
- Oct 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36114785 | IL | Primary |
Addresses
Primary practice location
800 Biesterfield Rd
Wimmer Suite 204
Elk Grove Village, IL 60007-3361
Mailing address
1181 Carberry Cir
Inverness, IL 60067-4289
Phone (630) 453-8819
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036114785 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2017 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36114785 | IL | MD | Family Medicine Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Elk Grove Village, IL
- NPI 1114035391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414540800000",
"number": "1821029323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1181 CARBERRY CIR",
"city": "INVERNESS",
"state": "IL",
"postal_code": "600674289",
"telephone_number": "630-453-8819",
"fax_number": "630-348-6248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 BIESTERFIELD RD",
"address_2": "WIMMER SUITE 204",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073361",
"telephone_number": "630-453-8819",
"fax_number": "630-348-6248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POZDAL",
"first_name": "JOANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2014-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "36114785",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036114785",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.