Roman O Kozyckyj, MD

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

036.063880 Issued in IL

Practice address

6345 W 79TH St
Burbank, IL 60459-1133

Phone

(844) 725-5238

NPI assigned

Jan 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Roman Orest Kozyckyj

  • Internal Medicine Physician
  • Oak Lawn, IL
  • NPI 1407998602
  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1184603961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 W 79TH ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591133",
            "telephone_number": "844-725-5238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 W 95th St",
            "address_2": "Suite 206",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532533",
            "country_code": "US",
            "telephone_number": "708-229-2240",
            "fax_number": "708-229-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6345 W 79th St",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "IL",
            "postal_code": "604591133",
            "country_code": "US",
            "telephone_number": "844-725-5238",
            "fax_number": "708-346-8285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZYCKYJ",
        "first_name": "ROMAN",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-063880",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036.063880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BC",
            "identifier": "01625872",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036063880",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkozyckyj206101@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6345 W 79th St",
            "city": "Burbank",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604591133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6345 W 79th St",
            "city": "Burbank",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604591133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mai Vo Kirwan
• Nahawand Hasan Kishta, APRN-FNP
• Edward George Klus, RPH.
• Kathy Elizabeth Komperda, PHARM.D.
• Michael Kowalik, DDS
• Lauren Kropke Buchina, PHARMD
• Grzegorz Krupa, DMD
• Amrendra Kumar
• Harshada Amrendra Kumar, OTR/L
• Mary Kumar, R.N.

• Hospice and Palliative Medicine (Internal Medicine) Physician in Burbank, IL
• Providers in Burbank, IL by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.