Active NPI
Erica Bolanowski
- Internal Medicine Physician
- Naperville, IL
National Provider Identifier
1891574323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 209027884
- Practice address
- 1020 E Ogden Ave Ste 206
Naperville, IL 60563-8610 - Phone
- (630) 237-4500
- NPI assigned
- Sep 25, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 209027884 | IL | Primary |
Addresses
Primary practice location
1020 E Ogden Ave Ste 206
Naperville, IL 60563-8610
Mailing address
1020 E Ogden Ave Ste 206
Naperville, IL 60563-8610
Phone (630) 857-3101
Other practice location 1
1325 Remington Rd Ste X
Schaumburg, IL 60173-4815
Phone (630) 409-1257
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209027884 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chicagoland Internal Medicine LLC | Past | Accepting new patients | |
| Mens Health Chicago LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Adult Health Nurse Practitioner
- Barrington, IL
- NPI 1366861304
-
- Adult Health Nurse Practitioner
- Bartlett, IL
- NPI 1104111848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1891574323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 E OGDEN AVE STE 206",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605638610",
"telephone_number": "630-857-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 E OGDEN AVE STE 206",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605638610",
"telephone_number": "630-237-4500"
}
],
"practiceLocations": [
{
"address_1": "1325 Remington Rd Ste X",
"address_purpose": "LOCATION",
"city": "Schaumburg",
"state": "IL",
"postal_code": "601734815",
"country_code": "US",
"telephone_number": "630-409-1257",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOLANOWSKI",
"first_name": "ERICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-25",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "209027884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.