Jack Dennis Zandstra

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1171553 Issued in IL

Practice address

40 75TH St
Willowbrook, IL 60527-2325

Phone

(630) 581-5372

NPI assigned

Sep 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Albany Medical College of Union University, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Midwest Express Care 2, Inc

  • Urgent Care Clinic/Center
  • Willowbrook, IL
  • NPI 1548692890
  Medicare reassignment Care Compare group NPD
• Midwest Express Care 2, Inc

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1659952554
  NPD

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1881362051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 75TH ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272325",
            "telephone_number": "630-581-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 75TH ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272325",
            "telephone_number": "630-581-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDSTRA",
        "first_name": "JACK",
        "middle_name": "DENNIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "1171553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Ann Wrobel, LCPC
• WSKC Dialysis Services, Inc.
• Rathna K Yallapragada, M.D.
• Richard Yelnick
• Mesude Yildiz
• Paula Zarco, FNP-BC
• Zary Chiropractic, LTD.
• Bernadetta Ewa Zawiejska
• Jacqueline Zepeda
• Yu Zhu, LIC.ACU.

• Physician Assistant in Willowbrook, IL
• Providers in Willowbrook, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.