Christopher Koenig, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085-005657 Issued in IL

Practice address

19550 Governors Hwy Ste 1400
Flossmoor, IL 60422

Phone

(708) 647-7565

NPI assigned

Sep 23, 2015

Last updated

Feb 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: ckoenig@mo1800.srs-direct.com

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.

• Ucm Medical Group Sub, LLC

  • Family Medicine Physician
  • Harvey, IL
  • NPI 1467442293
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1164891818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731277",
            "telephone_number": "708-862-7674",
            "fax_number": "708-862-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 GOVERNORS HWY STE 1400",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "60422",
            "telephone_number": "708-647-7565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10330 S Roberts Rd",
            "address_purpose": "LOCATION",
            "city": "Palos Hills",
            "state": "IL",
            "postal_code": "604651971",
            "country_code": "US",
            "telephone_number": "708-237-7200",
            "fax_number": "708-237-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-23",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085-005657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernadette King
• Lakeisha Kirby, LPC
• William G. Klipfel, M.D.
• Dale William Klooster, LCSW
• Rysa Shavonne Koch, M.A., LCPC
• Kimberly Kramer, RD, LDN
• Margaret Krol, LCSW
• Kimberly R Kruczek, D.O
• Lindsey Kulma, M.H.S., CCC-SLP/L
• John I Kung, M.D.

• Surgical Physician Assistant in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.