MEDICARE: JACQUELINE ANN PONGRACIC MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0201X	Pediatric Allergy/Immunology Physician	036083010	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083674048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE ANN PONGRACIC MD

Provider Business Mailing Address
First Line	:	2300 CHILDRENS PLAZA
Second Line	:	#60 CHILDRENS MEMORIAL HOSPITAL
City	:	CHICAGO
State	:	IL
Zip	:	60614
Country	:	US
Telephone Number	:	312-227-6011
Fax Number	:	312-227-9401

Provider Business Practice Location Address
First Line	:	2515 N CLARK ST
Second Line	:	CHILDRENS MEMORIAL HOSPITAL OUTPATIENT CENTER
City	:	CHICAGO
State	:	IL
Zip	:	60614
Country	:	US
Telephone Number	:	312-227-6010
Fax Number	:	312-227-9401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	09/21/2011

Similar Medicare Providers

1952361909 — RAJESH KUMAR MD
Practice Location Address:

2515 N CLARK ST , CHILDRENS MEMORIAL HOSPITAL OUTPATIENT CENTER
CHICAGO, IL
60614

Practice Phone: 312-227-6010
Practice Fax: 312-227-9401

1184677114 — CHRISTINE SZYCHLINSKI APN CPNP
Practice Location Address:

2515 CLARK ST
CHICAGO, IL
60614

Practice Phone: 312-227-6010
Practice Fax:

1558344788 — RAMSAY L FULEIHAN MD
Practice Location Address:

225 E CHICAGO AVE
CHICAGO, IL
60611-2991

Practice Phone: 312-227-6010
Practice Fax: 312-227-9401

1215997408 — BRIAN A SMART MD
Practice Location Address:

430 PENNSYLVANIA AVE
GLEN ELLYN, IL
60137-4464

Practice Phone: 630-469-9200
Practice Fax:

1649221953 — DR. JEFFREY RADFORD STOKES MD
Practice Location Address:

1 CHILDRENS PL , DIV PED ALLERGY/IMMUNO/PULMO
SAINT LOUIS, MO
63110-1002

Practice Phone: 314-454-2694
Practice Fax: 314-454-2515

1962455998 — MRS. LAUREN M PACHMAN MD
Practice Location Address:

225 E CHICAGO AVE , BOX 50
CHICAGO, IL
60611-2991

Practice Phone: 312-227-6270
Practice Fax: 312-227-9417

Directions to “ JACQUELINE ANN PONGRACIC MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.