Individual provider Active NPI

Kimberly A Czech, MD

  • Pediatric Nephrology Physician
  • Chicago, IL
National Provider Identifier
1245447416
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
036128744 Issued in IL
Practice address
1801 W Taylor St Ste 2E
Medical Staff Office
Chicago, IL 60612-4795
Phone
(312) 996-9291
Fax
(312) 355-4738
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 036128744 IL Primary

Addresses

Primary practice location

1801 W Taylor St Ste 2E
Medical Staff Office
Chicago, IL 60612-4795

Mailing address

840 S Wood St # Mc856
Chicago, IL 60612-4325
Phone (312) 996-9291

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
I20111024000324 IL Practitioner - Pediatric MedicinePractitioner - Nephrology 7214000249 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036128744ILMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Sep 7, 2011 Accepting new patients
Cook County CurrentSince Apr 21, 2022 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 7, 2011 Accepting new patients
Rush University Medical Group CurrentSince Jan 1, 2021 Accepting new patients
Mount Sinai Community Foundation CurrentSince Nov 1, 2014 Accepting new patients
Cook County CurrentSince Apr 21, 2022 Accepting new patients
Cook County Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Nov 1, 2014 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients

Locations

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

1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

75 Remittance Dr
Dept 1611
Chicago, IL 60675

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

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1801 W Taylor St
Ste 2E
Chicago, IL 60612
Phone (312) 996-7416

Interoperability endpoints

  • Direct secure messaging: kczech16977@uihealth.direct-ci.com

Organizations & group practices 10

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1245447416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST # MC856",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-9291",
            "fax_number": "312-355-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST STE 2E",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-996-9291",
            "fax_number": "312-355-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZECH",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "IL",
            "license": "036128744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.