Individual provider Active NPI

Katherine Bratkiv, PA-C

  • Physician Assistant
  • Oakbrook Terrace, IL
National Provider Identifier
1063140135
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085010124 Issued in IL
Practice address
17W755 Butterfield Rd
Oakbrook Terrace, IL 60181-4524
Phone
(630) 827-0100
NPI assigned
Aug 8, 2022
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085010124 IL Primary

Addresses

Primary practice location

17W755 Butterfield Rd
Oakbrook Terrace, IL 60181-4524

Mailing address

497 Senon Dr
Lemont, IL 60439-4082
Phone (630) 373-8532

Other practice location 1

497 Senon Dr
Lemont, IL 60439-4082
Phone (630) 373-8532

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124003577 IL Practitioner - Physician Assistant 8921451196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1063140135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 SENON DR",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394082",
            "telephone_number": "630-373-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17W755 BUTTERFIELD RD",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814524",
            "telephone_number": "630-827-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "497 Senon Dr",
            "address_purpose": "LOCATION",
            "city": "Lemont",
            "state": "IL",
            "postal_code": "604394082",
            "country_code": "US",
            "telephone_number": "630-373-8532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRATKIV",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

Verify at the official NPI Registry.