Athena Kostidis, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

36113445 Issued in IL

Practice address

2160 S 1St Ave
(17W740 22ND Street, Oakbrook Terrace, Il. 60181)
Maywood, IL 60153

Phone

(630) 627-7399

Fax

(630) 627-7079

NPI assigned

Jan 23, 2006

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

Other identifiers 1

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

Neurology

Education

Indiana University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akostidis15745@direct.luhs.org

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.

• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Loyola University Physician Foundation

  • General Practice Physician
  • Maywood, IL
  • NPI 1235148891
  NPD (past)

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

• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1386624575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "(17W740 22ND STREET, OAKBROOK TERRACE, IL. 60181)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "630-627-7399",
            "fax_number": "630-627-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "(17W740 22ND STREET, OAKBROOK TERRACE, IL. 60181)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "630-627-7399",
            "fax_number": "630-627-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTIDIS",
        "first_name": "ATHENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "36113445",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "36113445",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36113445",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Mei Koo
• Karli Anne Korsch, P.T. D.P.T
• Shelby Quinn Coulter Koschuck, DDS
• Hunter Roy Koster, MD
• Jorgena Kosti, D.O
• Ahmed Kotb
• Thomas Achilles Kotsonis, MD
• James M Kozeny, DPM
• Madonna Kral, MD
• Holly Kramer, MD

• Neurology Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; 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.