Individual provider Active NPI

Mariusz Tomasz Koziol I, M.D.

  • Obstetrics & Gynecology Physician
  • Elk Grove Village, IL
National Provider Identifier
1376752634
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036118758 Issued in IL
Practice address
810 Biesterfield Rd
Suite 306 - Wimmer Building
Elk Grove Village, IL 60007-3378
Phone
(847) 357-1144
Fax
(847) 357-9449
NPI assigned
May 22, 2007
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036118758 IL Primary
Obstetrics & Gynecology Physician 207V00000X 036.118758 IL

Addresses

Primary practice location

810 Biesterfield Rd
Suite 306 - Wimmer Building
Elk Grove Village, IL 60007-3378

Mailing address

810 Biesterfield Rd Ste 306
Elk Grove Village, IL 60007-3311
Phone (847) 357-1144

Other practice location 1

1614 W Central Rd Ste 101
Arlington Heights, IL 60005-2452
Phone (847) 392-9191

Other identifiers 2

IdentifierTypeStateIssuer
036118758-1MedicaidIL
11790234OtherCAQH

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
I20071204000612 IL Practitioner - Obstetrics/Gynecology 0749379394 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 Biesterfield Rd
Suite 306
Elk Grove Village, IL 60007-3378
Phone (847) 357-1144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.118758ILMDObstetrics & Gynecology Physician
036118758ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bonaventure Medical Foundation, LLC CurrentSince Aug 1, 2023 Accepting new patients
Midwest OB/GYN & Midwifery Obstetrics & Gynecology CurrentSince Oct 1, 2013 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology Current Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 1, 2025 Accepting new patients
Northwest Community Women Services LLC Obstetrics & Gynecology CurrentSince Jan 19, 2026 Accepting new patients
Northwest Community Healthcare Past Accepting new patients
Northwest Health Care Associates PastSince Mar 20, 2014 Accepting new patients

Locations

1614 W Central Rd
Ste 101
Arlington Heights, IL 60005
Phone (847) 392-9191

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

1051 W Rand Rd
Ste 101
Arlington Hts, IL 60004
Phone (847) 212-3885

29651 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

800 Biesterfield Rd
Ste 306
Elk Grove Vlg, IL 60007
Phone (847) 357-1144

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

Interoperability endpoints

  • FHIR API: https://epicprdproxy.nch.org/prd-fhir/api/FHIR/R4

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1376752634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 BIESTERFIELD RD STE 306",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-357-1144",
            "fax_number": "847-357-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 BIESTERFIELD RD",
            "address_2": "SUITE 306 - WIMMER BUILDING",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073378",
            "telephone_number": "847-357-1144",
            "fax_number": "847-357-9449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1614 W Central Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600052452",
            "country_code": "US",
            "telephone_number": "847-392-9191",
            "fax_number": "847-392-9811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZIOL",
        "first_name": "MARIUSZ",
        "middle_name": "TOMASZ",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036118758",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.118758",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036118758-1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11790234",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.