Elizabeth Anne Kiracofe, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036-141403 Issued in IL

Practice address

618 W Fulton St
Chicago, IL 60661-1144

Phone

(847) 766-0829

Fax

(847) 892-4992

NPI assigned

Jun 6, 2012

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.kiracofe.p1@direct.hcenter.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kiracofe MD Medical, LLC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1124675244
  Medicare reassignment Authorized official
• McDermott Center

  dba Haymarket Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1457004046
  Medicare reassignment NPD
• Physicians Dermpath Laboratory

  • Dermatopathology Physician
  • Park Ridge, IL
  • NPI 1376866897
  NPD (past)

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1336400217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 W FULTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611144",
            "telephone_number": "847-766-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 W FULTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611144",
            "telephone_number": "847-766-0829",
            "fax_number": "847-892-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRACOFE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-141403",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.021857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleni G Kioussis, PT, DPT, ATC
• Andrew M Kiper, D.C.
• Alina Kipnis, MS, CF-SLP
• Matthew Kippenhan, MD
• Kiracofe MD Medical, LLC
• David Kiragu, M.D.
• Jessica Kiragu
• Amy Kiraly, M.D.
• Kiran P Amin MDSC
• Kiran Polavarapu MD SC

• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.