NPIMap

Individual provider Active NPI

Andrius Kudirka, M.D.

  • Family Medicine Physician
  • Orland Park, IL
National Provider Identifier
1396790739
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036110338 Issued in IL
Practice address
15300 West Avenue
Suite 221 S.
Orland Park, IL 60462
Phone
(708) 590-5300
Fax
(708) 590-5310
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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 036110338 IL Primary

Addresses

Primary practice location

15300 West Avenue
Suite 221 S.
Orland Park, IL 60462

Mailing address

12251 S 80TH Ave
Suite 1630
Palos Heights, IL 60463-1256
Phone (708) 590-5300

Other identifiers 2

IdentifierTypeStateIssuer
036110338MedicaidIL
IL332310OtherILMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000368 IL Practitioner - Family Practice 1355395195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

15300 W Ave BLDG a
Suite 100
Orland Park, IL 60462-4600
Phone (708) 226-2626

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110338ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group Family Medicine CurrentSince Sep 1, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

1200 Maple Rd
Joliet, IL 60432
Phone (815) 740-1100

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

15300 West Ave
Ste 221
Orland Park, IL 60462
Phone (708) 349-0747

15300 West Ave
Ste 16221
Orland Park, IL 60462

15300 West Ave
Orland Park, IL 60462
Phone (708) 226-2440

15300 West Ave
Ste 122
Orland Park, IL 60462
Phone (708) 226-2400

12251 S 80th Ave
Ste 1630
Palos Heights, IL 60463
Phone (708) 923-5173

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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.

Hospital & facility affiliations 10

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1396790739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "address_2": "SUITE 1630",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-590-5300",
            "fax_number": "708-590-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 WEST AVENUE",
            "address_2": "SUITE 221 S.",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60462",
            "telephone_number": "708-590-5300",
            "fax_number": "708-590-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDIRKA",
        "first_name": "ANDRIUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036110338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110338",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL332310",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.