Individual provider Active NPI

Marianne Catherine Krupka, D.O.

  • Obstetrics Physician
  • Huntley, IL
National Provider Identifier
1215382999
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
036149752 Issued in IL
Practice address
10350 Haligus Rd Ste 120
Huntley, IL 60142-9526
Phone
(815) 356-2323
Fax
(847) 802-7201
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 036149752 IL Primary

Addresses

Primary practice location

10350 Haligus Rd Ste 120
Huntley, IL 60142-9526

Mailing address

10350 Haligus Rd Ste 120
Huntley, IL 60142-9526
Phone (815) 356-2323

Other names 1

  • Marianne Catherine Witham Former name

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
I20200818000571 IL Practitioner - Obstetrics/Gynecology 6204118391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lincoln Memorial University Medical Department, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

10350 Haligus Rd
Huntley, IL 60142-9545
Phone (847) 669-3880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Aug 17, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 17, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

750 E Terra Cotta Ave
Ste B
Crystal Lake, IL 60014
Phone (815) 356-2323

10350 Haligus Rd
Ste 120
Huntley, IL 60142
Phone (815) 356-2323

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1215382999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 HALIGUS RD STE 120",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429526",
            "telephone_number": "815-356-2323",
            "fax_number": "847-802-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 HALIGUS RD STE 120",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429526",
            "telephone_number": "815-356-2323",
            "fax_number": "847-802-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPKA",
        "first_name": "MARIANNE",
        "middle_name": "CATHERINE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "IL",
            "license": "036149752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANNE",
            "last_name": "WITHAM",
            "middle_name": "CATHERINE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntley, IL

Sources for this page

Verify at the official NPI Registry.