Individual provider Active NPI

Philip G Janicak, M.D.

  • Psychiatry Physician
  • Naperville, IL
National Provider Identifier
1891993754
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-050070 Issued in IL
Practice address
1335 N Mill St
Naperville, IL 60563-2261
Phone
(630) 646-8000
Fax
(630) 646-8007
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-050070 IL Primary

Addresses

Primary practice location

1335 N Mill St
Naperville, IL 60563-2261

Mailing address

1335 N Mill St
Naperville, IL 60563-2261
Phone (630) 646-8000

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
I20080112000112 IL Practitioner - Psychiatry 2567543887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Loyola University of Chicago, Stritch School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

676 N Saint Clair
Chicago, IL 60611-2927

676 N Saint Clair St
Chicago, IL 60611-2927

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-050070ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Sep 8, 2014 Accepting new patients
Edward Health Ventures CurrentSince Sep 8, 2014 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2016 Accepting new patients
Naperville Psychiatric Ventures Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1015
Chicago, IL 60611
Phone (312) 926-9674

8 Salt Creek Ln
Ste 202
Hinsdale, IL 60521
Phone (331) 221-2505

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

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.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1891993754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 N MILL ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632261",
            "telephone_number": "630-646-8000",
            "fax_number": "630-646-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 N MILL ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632261",
            "telephone_number": "630-646-8000",
            "fax_number": "630-646-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANICAK",
        "first_name": "PHILIP",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-050070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.