Physician Compare National (NPI:1376638700)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1376638700
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3779480595
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20031218000313
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BARTIZAL
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	FRANK
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	CHICAGO COLLEGE OF MEDICINE AND SURGERY
	Individual professional's medical school
Graduation Year	1965
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	HOUSECALL PHYSICIANS OF ILLINOIS SC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7810167830
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	28
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2003 W FULTON ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 303
	Group Practice or individual's line 2 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606122345
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3122432223
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140276
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LOYOLA UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140213
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SILVER CROSS HOSPITAL AND MEDICAL CENTERS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140252
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NORTHWEST COMMUNITY HOSPITAL 1
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	140007
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	PRESENCE SAINT JOSEPH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y