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DR. JACQUELINE SOUZA MD
NPI 1770636979
Pediatrics in Chicago, IL

Active since January 19, 2007PECOS Enrolled
5215 N CALIFORNIA AVE STE 601, CHICAGO, IL 60625(773) 878-3627(773) 989-1669 Get Directions Write a Review

NPPES record last updated: October 30, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 30, 2020, Feb 14, 2020 (2 updates tracked since 2020).

About Dr. Jacqueline Souza Md NPPES

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

DR. JACQUELINE SOUZA MD (NPI 1770636979) is an individual pediatrics provider in Chicago, Illinois, licensed in Illinois (36110540) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Aurora.

NPPES Registry Identity

NPI1770636979
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. JACQUELINE SOUZACredential: MD
Location Address5215 N CALIFORNIA AVE STE 601Chicago, IL 60625-8564
Mailing Address5215 N California Ave Ste 601Chicago, IL 60625-8564 · (773) 878-3627 · Fax (773) 989-1669
Phone(773) 878-3627
Fax(773) 989-1669
Sole ProprietorNo
Enumeration DateJanuary 19, 2007
Last NPPES UpdateOctober 30, 20202 updates tracked since enumeration
NPPES CertifiedOctober 30, 2020
✔ NPI 1770636979 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 36110540
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
5215 N CALIFORNIA AVE STE 601, Chicago, IL 60625
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Secondary Practice Location 1

Location 12000 Ogden AveAurora, IL 60504-7222 · Phone (630) 978-6200

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacqueline Souza Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jacqueline Souza reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Swedish Covenant Management Services, Inc
0.1 mi
Emergency Medicine
5140 N CALIFORNIA AVE
Chicago, IL 60625
  • Reassigned Medicare billing, Illinois enrollment
  • 350 clinicians in this Medicare group
NPI 1962049551 (847) 570-2040
Endeavor Health Medical Group
6.1 mi
Allergy & Immunology
1000 CENTRAL ST
Evanston, IL 60201
  • Reassigned Medicare billing, Illinois enrollment
  • 4,841 clinicians in this Medicare group
NPI 1497701882 (847) 570-5235

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60625 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

DR. DAVID EUGENE STIASNY M.D.
Pediatrics
5215 N CALIFORNIA AVE STE 601
CHICAGO, IL 60625
Cook County (773) 878-3627
DR. PARAV PATEL MD
Pediatrics
5215 N CALIFORNIA AVE STE 601
CHICAGO, IL 60625
Cook County (773) 878-3627

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 Jacqueline Souza's NPI number?

The NPI number for Jacqueline Souza is 1770636979. It was assigned to this individual provider in the NPPES registry on January 19, 2007.

Where is Jacqueline Souza located?

Jacqueline Souza practices at 5215 N California Ave Ste 601, Chicago, IL 60625. The listed phone number is (773) 878-3627.

What is Jacqueline Souza's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jacqueline Souza enrolled in Medicare?

Yes. Jacqueline Souza is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jacqueline Souza's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Souza reassigns Medicare benefits to 2 organizations: Swedish Covenant Management Services, Inc (Chicago, IL) and Endeavor Health Medical Group (Evanston, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Souza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacqueline Souza was last updated on October 30, 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.