Individual provider Active NPI

Beata Agnieszka Kisiel, M.D.

  • Nephrology Physician
  • Joliet, IL
National Provider Identifier
1033222104
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036-110897 Issued in IL
Practice address
3100 Theodore St Ste 201
Joliet, IL 60435-0605
Phone
(815) 744-5550
NPI assigned
Aug 15, 2006
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036-110897 IL Primary

Addresses

Primary practice location

3100 Theodore St Ste 201
Joliet, IL 60435-0605

Mailing address

120 W 22ND St
Oak Brook, IL 60523-1557
Phone (630) 573-5000

Other practice location 1

2121 Oneida St
Suite 103
Joliet, IL 60435-6544
Phone (815) 741-8480

Other practice location 2

1890 Silver Cross Blvd Ste 415
New Lenox, IL 60451-9575
Phone (815) 717-8750

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061110000132 IL Practitioner - NephrologyPractitioner - Internal Medicine 6608874441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3100 Theodore St
Suite 201
Joliet, IL 60435-0605
Phone (815) 905-2209

800 Biesterfield Rd
Elk Grove Village, IL 60007-3372
Phone (847) 981-3680

948 W US Route 6
Morris, IL 60450-8858
Phone (815) 744-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60 of 100Reported as individual
Quality
0
Promoting interoperability
99
Improvement activities
40
Cost
43.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-110897ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Illinois, LTD. Nephrology CurrentSince Oct 1, 2023 Accepting new patients
Nephrology Associates of Northern Illinois, LTD. Nephrology CurrentSince Oct 1, 2023 Accepting new patients
Linda Roberts & Associates Inc Past Accepting new patients
Northeast Nephrology Consultants Nephrology Past Accepting new patients

Locations

3223 W 63rd St
Chicago, IL 60629
Phone (773) 735-4884

3825 Highland Ave
Ste 4C
Downers Grove, IL 60515
Phone (630) 968-1595

800 Biesterfield Rd
Ste 104
Elk Grove Village, IL 60007
Phone (847) 593-9182

3100 Theodore St
Ste 201
Joliet, IL 60435
Phone (815) 744-5550

120 Spalding Dr
Ste 410
Naperville, IL 60540
Phone (630) 369-0780

1890 Silver Cross Blvd
Ste 415
New Lenox, IL 60451
Phone (815) 717-8750

120 W 22nd St
Oak Brook, IL 60523

Interoperability endpoints

  • Direct secure messaging: bkisiel35453@direct.davitaphysiciansolutions.com
  • Direct secure messaging: bkisiel59198@direct.acumenmd.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1033222104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231557",
            "telephone_number": "630-573-5000",
            "fax_number": "630-368-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 THEODORE ST STE 201",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604350605",
            "telephone_number": "815-744-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 Oneida St",
            "address_2": "SUITE 103",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604356544",
            "country_code": "US",
            "telephone_number": "815-741-8480",
            "fax_number": "815-741-8497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1890 Silver Cross Blvd Ste 415",
            "address_purpose": "LOCATION",
            "city": "New Lenox",
            "state": "IL",
            "postal_code": "604519575",
            "country_code": "US",
            "telephone_number": "815-717-8750",
            "fax_number": "815-717-8751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISIEL",
        "first_name": "BEATA",
        "middle_name": "AGNIESZKA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036-110897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.