Individual provider Active NPI

Amanda Mroczek, DO

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1972066751
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036160979 Issued in IL
Practice address
4025 N Western Ave BLDG E
Chicago, IL 60618-3726
Phone
(773) 275-7700
Fax
(773) 279-6504
NPI assigned
Apr 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1972066751 IL
Family Medicine Physician 207Q00000X 036160979 IL Primary

Addresses

Primary practice location

4025 N Western Ave BLDG E
Chicago, IL 60618-3726

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

4140 Southwest Hwy
Hometown, IL 60456-1135
Phone (708) 422-5700

Other practice location 2

9555 52nd Avenue
Suite F
Oak Lawn, IL 60453
Phone (708) 422-5700

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address amroczek228964@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address amroczek228964@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20220906003303 IL Practitioner - Internal Medicine 5294119509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

4025 N Western Ave
Chicago, IL 60618-3726
Phone (773) 275-7700

Hospital & facility affiliations

  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036160979ILMDFamily Medicine Physician
1972066751ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Aug 12, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 12, 2022 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

4025 N Western Ave
Bldg E
Chicago, IL 60618
Phone (773) 275-7700

4140 Southwest Hwy
Oak Lawn, IL 60456
Phone (708) 422-5700

9555 S 52nd Ave
Ste F
Oak Lawn, IL 60453
Phone (708) 422-5700

Interoperability endpoints

  • Direct secure messaging: amroczek228964@direct.myadvocateaurora.org

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 3

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1972066751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 N WESTERN AVE BLDG E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183726",
            "telephone_number": "773-275-7700",
            "fax_number": "773-279-6504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4140 Southwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Hometown",
            "state": "IL",
            "postal_code": "604561135",
            "country_code": "US",
            "telephone_number": "708-422-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9555 52nd Avenue",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "60453",
            "country_code": "US",
            "telephone_number": "708-422-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MROCZEK",
        "first_name": "AMANDA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "1972066751",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036160979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amroczek228964@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9555 52nd Avenue",
            "address_2": "Suite F",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9555 52nd Avenue",
            "address_2": "Suite F",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amroczek228964@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "4025 N Western Ave Bldg E",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606183726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4025 N Western Ave Bldg E",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606183726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.