Individual provider Active NPI

Julia Kizhner

  • Medical Physician Assistant
  • North Chicago, IL
National Provider Identifier
1437172400
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3001 Green Bay Rd
Primary Care
North Chicago, IL 60064-3048
Phone
(847) 688-1900
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X IL Primary

Addresses

Primary practice location

3001 Green Bay Rd
Primary Care
North Chicago, IL 60064-3048

Mailing address

3001 Green Bay Rd
Primary Care
North Chicago, IL 60064-3048

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130719000299 IL Order and Referring Only - Physician Assistant 4385663327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-001862ILMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437172400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "address_2": "PRIMARY CARE",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "address_2": "PRIMARY CARE",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "847-688-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZHNER",
        "first_name": "JULIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

Verify at the official NPI Registry.