Individual provider Active NPI

Adrianna M Kocik, FNP-C

  • Family Nurse Practitioner
  • Niles, IL
National Provider Identifier
1104531193
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209025068 Issued in IL
Practice address
7900 N Milwaukee Ave Ste 2-29
Niles, IL 60714-3237
Phone
(847) 454-9181
Fax
(847) 454-9184
NPI assigned
Jan 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 209025068 IL Primary

Addresses

Primary practice location

7900 N Milwaukee Ave Ste 2-29
Niles, IL 60714-3237

Mailing address

170 N Northwest Hwy Apt 318
Park Ridge, IL 60068-3357
Phone (847) 274-0663

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
209025068ILMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1104531193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 N NORTHWEST HWY APT 318",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683357",
            "telephone_number": "847-274-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE STE 2-29",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143237",
            "telephone_number": "847-454-9181",
            "fax_number": "847-454-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCIK",
        "first_name": "ADRIANNA",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.