Individual provider Active NPI

Andrew Segovia Kulik, MD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1245360411
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0064334 Issued in MD
Practice address
836 W Wellington Ave
Chicago, IL 60657-5147
Phone
(773) 883-0200
Fax
(773) 883-0090
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0064334 MD Primary

Addresses

Primary practice location

836 W Wellington Ave
Chicago, IL 60657-5147

Mailing address

938 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 883-0200

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
I20041029000876 IL Practitioner - Psychiatry 2668434838 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0064334MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Psychiatry CurrentSince Dec 1, 2014 Accepting new patients
Cook County CurrentSince Dec 1, 2014 Accepting new patients
Saint Anthony Health Affiliates Psychiatry CurrentSince Apr 23, 2022 Accepting new patients
Cook County Current Accepting new patients
Perspective Behavioral and Pain Solutions LTD CurrentSince Nov 1, 2021 Accepting new patients
Saint Anthony Health Affiliates Psychiatry CurrentSince Apr 23, 2022 Accepting new patients
Dixon F Spivy MD, LLC Psychiatry Past Accepting new patients
Chicago Physician Associates,LLC Psychiatry PastSince Oct 1, 2009 Accepting new patients
Oak Forest Psychological Service Psychiatry Past Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1900 W Polk St
Ste 1200
Chicago, IL 60612

4177 S Archer Ave
Chicago, IL 60632
Phone (773) 254-2222

2720 S River Rd
Ste 246
Des Plaines, IL 60018
Phone (847) 306-7277

2720 S River Rd
Ste 130
Des Plaines, IL 60018
Phone (224) 470-6107

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1245360411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-883-0200",
            "fax_number": "773-883-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-883-0200",
            "fax_number": "773-883-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULIK",
        "first_name": "ANDREW",
        "middle_name": "SEGOVIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0064334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.