Individual provider Active NPI

Karol A. Gutowski, MD

  • Plastic Surgery Physician
  • Glenview, IL
National Provider Identifier
1134198799
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
036.121999 Issued in IL
Practice address
2300 Chestnut Ave # 100
Glenview, IL 60026-1602
Phone
(773) 870-0732
Fax
(847) 780-1188
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 036.121999 IL Primary

Addresses

Primary practice location

2300 Chestnut Ave # 100
Glenview, IL 60026-1602

Mailing address

1526 Kittyhawk LN
Glenview, IL 60026-7755
Phone (773) 870-0732

Other identifiers 2

IdentifierTypeStateIssuer
0094902MedicaidOH
32142500MedicaidWI

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
I20141117001528 IL Practitioner - Plastic and Reconstructive Surgery 9537158159 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.121999ILMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jan 12, 2015 Accepting new patients
Mount Sinai Community Foundation CurrentSince Nov 1, 2014 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
The Board of Trustees of the University of Illinois Plastic Surgery CurrentSince Jan 12, 2015 Accepting new patients
Sinai Community Foundation CurrentSince Nov 1, 2014 Accepting new patients

Locations

1801 W Taylor St
#3F
Chicago, IL 60612
Phone (312) 355-4300

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

Organizations & group practices 6

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1134198799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 KITTYHAWK LN",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600267755",
            "telephone_number": "773-870-0732",
            "fax_number": "847-780-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CHESTNUT AVE # 100",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261602",
            "telephone_number": "773-870-0732",
            "fax_number": "847-780-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTOWSKI",
        "first_name": "KAROL",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036.121999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094902",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32142500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.