Mark Kosanovich, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036100871 Issued in IL

Practice address

2525 S Michigan Ave
B-390
Chicago, IL 60616-2333

Phone

(312) 567-6691

Fax

(312) 328-7895

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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, TX2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

Rush Medical College of Rush University, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Community Health Services, IncGroup PAC ID 7911969092, 153 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkosanovich2990@direct.rush.rush-health.com

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.

• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1679524961
  Medicare reassignment Care Compare group NPD
• Dynamic Anesthesia Providers PLLC

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1346752326

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment NPD
• Pathology Consultants of Chicago, LTD.

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
  • NPI 1689690562
  NPD
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Pasadena, TX
  • NPI 1609762889
  NPD
• Edna Richard M D

  • Gynecology Physician
  • Chicago, IL
  • NPI 1841405396
  NPD (past)
• San Jacinto Methodist Hospital

  • General Acute Care Hospital
  • Baytown, TX
  • NPI 1891789772
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1275517401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "address_2": "B-390",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-6691",
            "fax_number": "312-328-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "address_2": "B-390",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-6691",
            "fax_number": "312-328-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSANOVICH",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036100871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01621679",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100871",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Max Von Korzec, MD
• Michelle Elisabeth Korzec, CNM
• Iwona Korzeniowska, PT
• Addison James Korzun, PA-C
• Stephanie Kos, LMT
• Phaibul Kosaphandhu, M.D.
• Matthew John Koscica, M.D.
• Michael Koscielniak, MD
• Zuzanna Koscielniak
• Michael John Koscinski, DDS

• Obstetrics & Gynecology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.

Verify at the official NPI Registry.