Active NPI
Jerome J Skurka, MD
- Pediatrics Physician
- Oswego, IL
National Provider Identifier
1871609016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036-058962
- Practice address
- 80 Templeton Dr
Oswego, IL 60543-7000 - Phone
- (630) 554-3456
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036-058962 | IL | Primary |
Addresses
Primary practice location
80 Templeton Dr
Oswego, IL 60543-7000
Mailing address
2357 Sequoia Dr
Aurora, IL 60506-6222
Phone (630) 859-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036058962 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-058962 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1871609016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2357 SEQUOIA DR",
"city": "AURORA",
"state": "IL",
"postal_code": "605066222",
"telephone_number": "630-859-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 TEMPLETON DR",
"city": "OSWEGO",
"state": "IL",
"postal_code": "605437000",
"telephone_number": "630-554-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKURKA",
"first_name": "JEROME",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-058962",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036058962",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oswego, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.