NPIMap

Individual provider Active NPI

Ethan Chad Kosova, M.D., M.P.H.

  • Cardiovascular Disease Physician
  • Westmont, IL
National Provider Identifier
1053674002
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036137166 Issued in IL
Practice address
303 W Ogden Ave FL 3
Westmont, IL 60559-1419
Phone
(630) 435-6100
NPI assigned
Jun 24, 2012
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036137166 IL Primary
Hospitalist Physician 208M00000X 036137166 IL

Addresses

Primary practice location

303 W Ogden Ave FL 3
Westmont, IL 60559-1419

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ekosova194703@dulyhealthandcare.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160106001558 IL Practitioner - Interventional CardiologyPractitioner - HospitalistPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5890933139 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Northwestern University Feinberg Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

3825 Highland Ave
Suite 210
Downers Grove, IL 60515-1561
Phone (630) 435-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting20
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Hospital Association CurrentSince Oct 8, 2019 Accepting new patients
Edward Hospital CurrentSince Jun 8, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Dec 17, 2015 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Dec 17, 2015 Accepting new patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Elmhurst Memorial Hospital CurrentSince Mar 2, 2022 Accepting new patients
Naperville Psychiatric Ventures CurrentSince Mar 2, 2022 Accepting new patients
Central Dupage Hospital Association CurrentSince Oct 8, 2019 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 19, 2019 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 19, 2019 Accepting new patients
Naperville Psychiatric Ventures CurrentSince Mar 2, 2022 Accepting new patients
Edward Hospital Cardiovascular Disease CurrentSince Jun 8, 2022 Accepting new patients

Locations

303 W Lake St
Ste 301
Addison, IL 60101
Phone (331) 221-1650

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

Dept 5777
Carol Stream, IL 60122

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

680 N Lake Shore Dr
Ste 810
Chicago, IL 60611
Phone (312) 926-8811

3825 Highland Ave
Ste 210
Downers Grove, IL 60515
Phone (630) 435-6100

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

852 S West St
Naperville, IL 60540
Phone (630) 305-5027

303 W Ogden Ave
Fl 3
Westmont, IL 60559
Phone (630) 377-3814

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/

Organizations & group practices 12

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 5

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": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1053674002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W OGDEN AVE FL 3",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591419",
            "telephone_number": "630-435-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSOVA",
        "first_name": "ETHAN",
        "middle_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-24",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036137166",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036137166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekosova194703@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "303 W Ogden Ave Fl 3",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605591419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.