Individual provider Active NPI

John M. Jaworowicz, M.D.

  • Anesthesiology Physician
  • Loves Park, IL
National Provider Identifier
1871520205
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036070743 Issued in IL
Practice address
2202 Harlem Rd
Loves Park, IL 61111-2754
Phone
(815) 877-4848
Fax
(815) 654-5342
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036070743 IL Primary

Addresses

Primary practice location

2202 Harlem Rd
Loves Park, IL 61111-2754

Mailing address

2202 Harlem Rd
Loves Park, IL 61111-2754
Phone (815) 877-4848

Other identifiers 2

IdentifierTypeStateIssuer
036070743MedicaidIL
008664OtherHEALTH ALLIANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjaworowicz139699@direct.luhs.org Direct LOYOLA UNIVERSITY MEDICAL CENTER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050421001286 IL Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 2163460973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Medical College of Wisconsin, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Jun 1, 2021 Accepting new patients
Loyola University Medical Center CurrentSince Jun 1, 2021 Accepting new patients
Anesthesiology Consultants LTD Anesthesiology Past Accepting new patients
Rockford Anesthesiologists Associated, L.L.C. Anesthesiology Past Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1871520205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 HARLEM RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 HARLEM RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWOROWICZ",
        "first_name": "JOHN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036070743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070743",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "008664",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjaworowicz139699@direct.luhs.org",
            "affiliation": "Y",
            "endpointDescription": "jjaworowicz139699@direct.luhs.org",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

Verify at the official NPI Registry.