Individual provider Active NPI

Ala Klimuk, M.D.

  • Family Medicine Physician
  • Schaumburg, IL
National Provider Identifier
1366637480
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-119159 Issued in IL
Practice address
1375 E Schaumburg Rd
Suite 100
Schaumburg, IL 60194-5166
Phone
(847) 891-6850
Fax
(630) 339-5803
NPI assigned
Sep 11, 2007
Last updated
Mar 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-119159 IL Primary

Addresses

Primary practice location

1375 E Schaumburg Rd
Suite 100
Schaumburg, IL 60194-5166

Mailing address

1375 E Schaumburg Rd
Suite 100
Schaumburg, IL 60194-5166
Phone (847) 891-6850

Other identifiers 1

IdentifierTypeStateIssuer
036-119159OtherILSTATE LICENCE

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
I20071026000411 IL Practitioner - Family Practice 4082701859 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-119159ILMDFamily Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1366637480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 E SCHAUMBURG RD",
            "address_2": "SUITE 100",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601945166",
            "telephone_number": "847-891-6850",
            "fax_number": "630-339-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 E SCHAUMBURG RD",
            "address_2": "SUITE 100",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601945166",
            "telephone_number": "847-891-6850",
            "fax_number": "630-339-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMUK",
        "first_name": "ALA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-119159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "036-119159",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.