Individual provider Active NPI

Andrzej Jozef Gacek, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1871543694
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.117533 Issued in IL
Practice address
5901 N Milwaukee Ave Ste D
Chicago, IL 60646-5400
Phone
(773) 631-1300
Fax
(773) 631-3971
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.117533 IL Primary

Addresses

Primary practice location

5901 N Milwaukee Ave Ste D
Chicago, IL 60646-5400

Mailing address

5901 N Milwaukee Ave Ste D
Chicago, IL 60646-5400
Phone (773) 631-1300

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
I20080808000804 IL Practitioner - Internal Medicine 8123030863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5901 N Milwaukee Ave
Suite D
Chicago, IL 60646-5400
Phone (773) 631-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.117533ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andrzej Gacek Medical , LLC Internal Medicine CurrentSince Jan 1, 2008 Accepting new patients
Excel Medical Care PastSince Jan 10, 2007 Accepting new patients
Care 4 U Medical PC PastSince Nov 15, 2006 Accepting new patients

Locations

5901 N Milwaukee Ave
Chicago, IL 60646

5901 N Milwaukee Ave
Ste D
Chicago, IL 60646
Phone (773) 631-1300

Organizations & group practices 3

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1871543694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 N MILWAUKEE AVE STE D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465400",
            "telephone_number": "773-631-1300",
            "fax_number": "773-631-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N MILWAUKEE AVE STE D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465400",
            "telephone_number": "773-631-1300",
            "fax_number": "773-631-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GACEK",
        "first_name": "ANDRZEJ",
        "middle_name": "JOZEF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.117533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.