Individual provider Active NPI

Michael Eugene Kupkowski, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1598081598
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125-058820 Issued in IL
Practice address
2001 W Addison St
Chicago, IL 60618-6132
Phone
(773) 796-2280
NPI assigned
Apr 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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 125-058820 IL Primary

Addresses

Primary practice location

2001 W Addison St
Chicago, IL 60618-6132

Mailing address

2001 W Addison St
Chicago, IL 60618-6132
Phone (773) 796-2280

Other practice location 1

3231 Euclid Ave
5th Floor
Berwyn, IL 60402-3471
Phone (708) 783-2000

Other practice location 2

3231 Euclid Ave
5th Floor
Berwyn, IL 60402-3471
Phone (708) 783-2000

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
I20140414000998 IL Practitioner - Family Practice 2466684048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Windy City Health Partners PLLCGroup PAC ID 2163891011, 3 clinicians

Practice addresses (Care Compare)

2001 W Addison St
Suite 1
Chicago, IL 60618-6132
Phone (773) 796-2280

Hospital & facility affiliations

  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-058820ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Health Partners PLLC Family Medicine CurrentSince Oct 25, 2022 Accepting new patients
Michigan Avenue ENT P.C. Current Accepting new patients

Locations

180 N Michigan Ave
Ste 1605
Chicago, IL 60601
Phone (312) 201-1234

2001 W Addison St
Ste 1
Chicago, IL 60618
Phone (773) 796-2280

Interoperability endpoints

  • Direct secure messaging: mkupkowski283737@direct.myadvocateaurora.org

Organizations & group practices 3

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 2

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1598081598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186132",
            "telephone_number": "773-796-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186132",
            "telephone_number": "773-796-2280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3231 Euclid Ave",
            "address_2": "5th Floor",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023471",
            "country_code": "US",
            "telephone_number": "708-783-2000",
            "fax_number": "708-783-3656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3231 Euclid Ave",
            "address_2": "5th Floor",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023471",
            "country_code": "US",
            "telephone_number": "708-783-2000",
            "fax_number": "708-783-3656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPKOWSKI",
        "first_name": "MICHAEL",
        "middle_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-058820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.