Marina A Kuznetsova, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

036090595 Issued in IL

Practice address

100 Provena Way Ste 103
Bourbonnais, IL 60914-4797

Phone

(773) 564-5070

Fax

(773) 564-5071

NPI assigned

Aug 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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

Locations

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.

• Ludag LLC

  • Radiation Oncology Physician
  • Merrillville, IN
  • NPI 1336195353

  IL

  Medicare reassignment NPD
• Ludag LLC

  • Radiation Oncology Physician
  • Gary, IN
  • NPI 1871685461
  NPD
• Ctca Physicians Group of Illinois, Inc

  • Medical Oncology Physician
  • Chicago, IL
  • NPI 1073015236
  NPD (past)
• Radiation Oncology Consultants, LTD

  • Radiation Oncology Physician
  • Oak Brook, IL
  • NPI 1164412417
  NPD (past)
• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  NPD (past)
• VHS Acquisition Subsidiary Number 3 Inc

  • Rehabilitation Hospital Unit
  • Chicago, IL
  • NPI 1871572545
  NPD (past)
• Ludag LLC Dba Cancer Treatment Group

  • Radiation Oncology Physician
  • La Porte, IN
  • NPI 1376635961
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1265545271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85327",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895327",
            "telephone_number": "814-237-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROVENA WAY STE 103",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144797",
            "telephone_number": "773-564-5070",
            "fax_number": "773-564-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZNETSOVA",
        "first_name": "MARINA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036090595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "01632270",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090575",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Kruchten
• Chelsea Krug, DPT
• KT Care LLC
• Craig Kuchenthal
• Ahamed V.P. Kutty, M.D.
• Grazelda Kwakye-Ackah, MD
• Cassandra J Lacher, DO
• Lafayette Med, PLLC
• Heather Nicole Lafond, LPC
• Jeanne Therese Laird, RDN LDN

• Radiation Oncology Physician in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Radiation Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.