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JEFFERSON PARK MEDICAL GROUP, P.C.
NPI 1366490047
Family Medicine in Chicago, IL

Active since May 04, 2006CLIA 14D1012161 · Waiver
5906 N MILWAUKEE AVE, CHICAGO, IL 60646(773) 774-7300(773) 774-7313 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jefferson Park Medical Group, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFERSON PARK MEDICAL GROUP, P.C. (NPI 1366490047) is a healthcare organization registered as a family medicine in Chicago, Illinois and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through May 1, 2027 and lists Richard Ansfield, Director, as its authorized official.

NPPES Registry Identity

NPI1366490047
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJEFFERSON PARK MEDICAL GROUP, P.C.
Location Address5906 N MILWAUKEE AVEChicago, IL 60646-5420
Mailing Address5906 N Milwaukee AveChicago, IL 60646-5420 · (773) 774-7300 · Fax (773) 774-7313
Phone(773) 774-7300
Fax(773) 774-7313
Organization SubpartNo
Authorized OfficialRichard AnsfieldDirector · (773) 774-7300
Enumeration DateMay 4, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1366490047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5906 N MILWAUKEE AVE, Chicago, IL 60646
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Other Identifiers 1

Other01630200IL · Blue Cross Number

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1012161

Jefferson Park Medical Group PC · Chicago, IL
Active · expires May 1, 2027
CLIA Number14D1012161
Laboratory TypeCommunity Clinic
Certificate Effective DateMay 2, 2025
Certificate Expiration DateMay 1, 2027
Laboratory DirectorRobert M. Kaplan
Laboratory Phone(773) 774-7300
Laboratory LocationJefferson Park Medical Group PC5906 N Milwaukee Ave Suite 8, Chicago, IL 60646
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FITSJOY THERAPY, LLC
Clinic/Center (Physical Therapy)
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300
ROBERT KAPLAN MD
Family Medicine
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300
LISA TUTAJ PA-C
Physician Assistant
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300
DR. BHADRA SHAH
Family Medicine
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300
LISA ATAEE FNP
Nurse Practitioner (Family)
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300
AMERICA'S DISABLED INC
Family Medicine
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300
AMERICAS DISABLED HOMEBOUND INC.
Family Medicine
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300
CLEAR IMAGE DIAGNOSTICS INC.
Clinical Medical Laboratory
5906 N MILWAUKEE AVE
CHICAGO, IL 60646
Cook County (773) 774-7300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jefferson Park Medical Group, P.C.'s NPI number?

The NPI number for Jefferson Park Medical Group, P.C. is 1366490047. It was assigned to this organization in the NPPES registry on May 4, 2006.

Where is Jefferson Park Medical Group, P.C. located?

Jefferson Park Medical Group, P.C. is located at 5906 N Milwaukee Ave, Chicago, IL 60646. The listed phone number is (773) 774-7300.

What is Jefferson Park Medical Group, P.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Jefferson Park Medical Group, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1012161) is associated with this NPI, valid through May 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jefferson Park Medical Group, P.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.