Individual provider Active NPI

Mary Kulikowski, FNP

  • Adult Care Home Facility
  • Chicago, IL
National Provider Identifier
1083018162
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
041.107696 Issued in IL
Practice address
5547 N Ravenswood Ave
Chicago, IL 60640-1125
Phone
(773) 769-4313
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 041.107696 IL Primary

Addresses

Primary practice location

5547 N Ravenswood Ave
Chicago, IL 60640-1125

Mailing address

5547 N Ravenswood Ave
Chicago, IL 60640-1125
Phone (773) 769-4313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041.107696ILMDAdult Care Home Facility

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1083018162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5547 N RAVENSWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401125",
            "telephone_number": "773-769-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5547 N RAVENSWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401125",
            "telephone_number": "773-769-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULIKOWSKI",
        "first_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "IL",
            "license": "041.107696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.