Individual provider Active NPI

Alicja Kraska-Cwikla, M.D.

  • Internal Medicine Physician
  • Orland Park, IL
National Provider Identifier
1093802712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36099771 Issued in IL
Practice address
15614 S Harlem Ave
Suite D
Orland Park, IL 60462-4402
Phone
(708) 444-0097
Fax
(708) 444-8252
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36099771 IL Primary
Internal Medicine Physician 207R00000X 200000859 NC

Addresses

Primary practice location

15614 S Harlem Ave
Suite D
Orland Park, IL 60462-4402

Mailing address

15614 S Harlem Ave
Suite D
Orland Park, IL 60462-4402
Phone (708) 444-0097

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
I20060213000796 IL Practitioner - Internal Medicine 3678588613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15614 S Harlem Ave
Suite D
Orland Park, IL 60462-4401
Phone (708) 444-0097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36099771ILMDInternal Medicine Physician
200000859NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Med-Peds Specialists S.C. Internal Medicine CurrentSince Dec 19, 2005 Accepting new patients
Lenoir Memorial Hospital, Incorporated Past Accepting new patients
Lenoir Memorial Hospital, Incorporated Past Accepting new patients

Locations

15614 S Harlem Ave
Ste D
Orland Park, IL 60462
Phone (708) 212-2212

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093802712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15614 S HARLEM AVE",
            "address_2": "SUITE D",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624402",
            "telephone_number": "708-444-0097",
            "fax_number": "708-444-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15614 S HARLEM AVE",
            "address_2": "SUITE D",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624402",
            "telephone_number": "708-444-0097",
            "fax_number": "708-444-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASKA-CWIKLA",
        "first_name": "ALICJA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36099771",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200000859",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.