Kevin M Koutsky, M.D.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

036089628 Issued in IL

Practice address

950 N York Rd Ste 109
Hinsdale, IL 60521-8608

Phone

(630) 528-2000

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Dupage Spine and Orthopaedics

  • Orthopaedic Surgery of the Spine Physician
  • Hinsdale, IL
  • NPI 1275167306

  Orthopaedic Surgery of the Spine

  NPD Authorized official
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1043225899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N YORK RD STE 109",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605218608",
            "telephone_number": "630-528-2000",
            "fax_number": "630-552-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N YORK RD STE 109",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605218608",
            "telephone_number": "630-528-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Butterfield Rd",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601265017",
            "country_code": "US",
            "telephone_number": "630-834-0491",
            "fax_number": "630-834-0735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUTSKY",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IL",
            "license": "036089628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036089628",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089628",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Kopolovic, MD
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• Kate Elise Kortenhoeven, MSW
• Matthew M Koschnitzky, ATC
• Miroslav Kovacevic, M.D.
• Linden Kovarik
• Michael Joseph Kowalczyk, D.D.S.
• Komal D. Koya, D.O
• Daniel E Krauss, M.D.

• All providers in Hinsdale, IL
• Orthopaedic Surgery of the Spine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.