Active NPI
Daniel R Kowalzyk, DO
- Emergency Medicine Physician
- Blue Island, IL
National Provider Identifier
1184647752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Practice address
- 12935 S. Gregory St.
Blue Island, IL 60406 - Phone
- (708) 597-2000
- Fax
- (708) 824-4494
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | IL | Primary |
Addresses
Primary practice location
12935 S. Gregory St.
Blue Island, IL 60406
Mailing address
533 W North Ave
102
Elmhurst, IL 60126-2135
Phone (800) 732-1066
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Midwestern University, Chicago College of Osteopathic Med, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Ingalls Dr
Harvey, IL 60426-3558
Phone (954) 939-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036081146 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harvey Emergency Physicians, PLLC | Emergency Medicine | Current | Accepting new patients |
| Em Strategies,LTD. | Emergency Medicine | Past | Accepting new patients |
| Illinois/Indiana Em-I Medical Services, S.C. | Emergency Medicine | Past | Accepting new patients |
| Midwest Emergency Northern Illinois Inc | Emergency Medicine | Past | Accepting new patients |
Locations
1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300
Interoperability endpoints
- dkowalzykdo237204@uchospital.direct-ci.com
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Calumet City, IL
- NPI 1184281651
-
- Emergency Medicine Physician
- New Lenox, IL
- NPI 1679791834
-
- Emergency Medicine Physician
- Blue Island, IL
- NPI 1710926647
-
- Emergency Medicine Physician
- Ottawa, IL
- NPI 1427217504
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Harvey, IL
- NPI 1598756686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184647752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533 W NORTH AVE",
"address_2": "102",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601262135",
"telephone_number": "800-732-1066",
"fax_number": "630-941-4333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12935 S. GREGORY ST.",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "60406",
"telephone_number": "708-597-2000",
"fax_number": "708-824-4494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOWALZYK",
"first_name": "DANIEL",
"middle_name": "R",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blue Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.