Active NPI
Andrew Kontrick, MD
- Emergency Medicine Physician
- Skokie, IL
National Provider Identifier
1508805433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Practice address
- 9600 Gross Point Rd
Skokie, IL 60076-1214 - Phone
- (904) 805-1300
- Fax
- (904) 805-1302
- NPI assigned
- Jun 6, 2006
- Last updated
- Jan 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | IL | Primary |
Addresses
Primary practice location
9600 Gross Point Rd
Skokie, IL 60076-1214
Mailing address
PO Box 758733
Baltimore, MD 21275-0001
Phone (904) 805-1300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01620446 | Other | IL | BLUE CROSS |
| 0360458582 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Princeton Emergency Services, LLC | Emergency Medicine | Past | Accepting new patients |
| Skokie Emergency Services, LLC | Emergency Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Nurse Practitioner
- Princeton, IL
- NPI 1134187875
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1508805433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 758733",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212750001",
"telephone_number": "904-805-1300",
"fax_number": "904-805-1302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 GROSS POINT RD",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761214",
"telephone_number": "904-805-1300",
"fax_number": "904-805-1302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONTRICK",
"first_name": "ANDREW",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "01620446",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360458582",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.