Andrew Peter Krivoshik, M.D., PH.D.

Primary specialty

Clinical Pharmacology PhysicianTaxonomy code 208U00000X

License

036111634 Issued in IL

Practice address

421 E Center Ave
Lake Bluff, IL 60044-2507

Phone

(847) 735-9737

NPI assigned

Dec 11, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

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    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1316345077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 E CENTER AVE",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442507",
            "telephone_number": "847-735-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 E CENTER AVE",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442507",
            "telephone_number": "847-735-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIVOSHIK",
        "first_name": "ANDREW",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-11",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1015840",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200200389",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "42674",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036111634",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301113666",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "69592-20",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NC",
            "license": "200200389",
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "MA",
            "license": "1015840",
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "IL",
            "license": "036111634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kocanda, PT, DPT, LMT
• Shirley A. Kosko, PSYD
• Amie Kramp, OTR/L
• Victoria Kranz, MD
• Olga Kras
• Amie Krummick, PH.D
• Pooja P Kshirsagar, PHARMD
• Myles Cole Kugler
• Saedy Lynn Kugler
• Douglas S Labelle, LCSW

• Clinical Pharmacology Physician in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Clinical Pharmacology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.