Organization Active NPI

Kathryn Skolarz, M.D., S.C.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1023465655
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036136435 Issued in IL
Legal business name
KATHRYN SKOLARZ, M.D., S.C.
Practice address
7447 W Talcott Ave
Suite 366
Chicago, IL 60631-3745
Phone
(773) 594-1410
Fax
(773) 774-1402
NPI assigned
May 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Authorized official

Name
Kathryn Skol, M.D.
Title
Physician
Phone
(312) 505-6577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036136435 IL Primary

Addresses

Primary practice location

7447 W Talcott Ave
Suite 366
Chicago, IL 60631-3745

Mailing address

7447 W Talcott Ave
Suite 366
Chicago, IL 60631-3745
Phone (773) 594-1410

Other identifiers 1

IdentifierTypeStateIssuer
1114272945OtherILNPI TYPE 1

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160603001237 IL Part B Supplier - Clinic/Group Practice 8123318151 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

7447 W Talcott Ave
Ste 366
Chicago, IL 60631
Phone (773) 594-1410

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1023465655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 366",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-594-1410",
            "fax_number": "773-774-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 366",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-594-1410",
            "fax_number": "773-774-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN SKOLARZ, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "SKOL",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "312-505-6577",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036136435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1114272945",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.