MK Medical Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036111568 Issued in IL

Legal business name

MK MEDICAL GROUP LLC

Practice address

5729 W Cermak Rd
Cicero, IL 60804-2129

Phone

(708) 477-6525

NPI assigned

May 31, 2010

Organization subpart

No

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

Authorized official

Name

Milena Kyoutchoukova, M.D.

Title

Owner

Phone

(708) 691-1429

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1013236090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N DEARBORN ST",
            "address_2": "704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5729 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042129",
            "telephone_number": "708-477-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-31",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "KYOUTCHOUKOVA",
        "authorized_official_first_name": "MILENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-691-1429",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036111568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Express Care 2, Inc
• Laura Kaufman Minardi, MD
• Gittel Mindick, PA-C
• Daisy Miranda
• Jenna Mixon, DPT
• ML Medical Services Corporation
• Anabel Molina
• Elizabeth Momeyer, MOT, OTR/L
• Richard Moncebaiz, D.C.
• Monil P Shah DMD PC

• Internal Medicine Physician in Cicero, IL
• Providers in Cicero, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.