Individual provider Active NPI

Henry Kurzydlowski, M.D.

  • Anesthesiology Physician
  • Niles, IL
National Provider Identifier
1073570198
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036068168 Issued in IL
Practice address
7437 N Harlem Ave
Niles, IL 60714-3701
Phone
(847) 387-3864
NPI assigned
May 1, 2006
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036068168 IL Primary
Interventional Pain Medicine Physician 208VP0014X 036068168 IL

Addresses

Primary practice location

7437 N Harlem Ave
Niles, IL 60714-3701

Mailing address

7437 N Harlem Ave
Niles, IL 60714-3701
Phone (847) 387-3864

Other identifiers 1

IdentifierTypeStateIssuer
036068168MedicaidIL

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
I20040301000882 IL Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Interventional Pain Management 6800781642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7200 N Western Ave
Chicago, IL 60645-1812
Phone (773) 761-6900

7437 N Harlem Ave
Niles, IL 60714-3701
Phone (847) 387-3864

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Care Advisors, LLC CurrentSince Oct 13, 2018 Accepting new patients
Moore Health SC Past Accepting new patients
Illinois Sports Medicine & Orthopedic Surgery Center, LLC PastSince Apr 1, 2008 Accepting new patients

Locations

3536 W Fullerton Ave
Chicago, IL 60647
Phone (773) 772-1212

7200 N Western Ave
Chicago, IL 60645
Phone (773) 743-6700

7437 N Harlem Ave
Niles, IL 60714
Phone (847) 387-3864

Organizations & group practices 3

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1073570198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7437 N HARLEM AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143701",
            "telephone_number": "847-387-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7437 N HARLEM AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143701",
            "telephone_number": "847-387-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURZYDLOWSKI",
        "first_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036068168",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036068168",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068168",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.