Individual provider Active NPI

Cezary A Kakol, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1598847873
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036095320 Issued in IL
Practice address
6508 W Archer Ave
Chicago, IL 60638
Phone
(773) 586-2220
Fax
(773) 586-0086
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036095320 IL Primary

Addresses

Primary practice location

6508 W Archer Ave
Chicago, IL 60638

Mailing address

6508 W Archer Ave
Chicago, IL 60638
Phone (773) 586-2220

Other identifiers 1

IdentifierTypeStateIssuer
036095320MedicaidIL

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
I20101112000591 IL Practitioner - Internal Medicine 4183819329 Practice locations: Chicago, IL; Melrose Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6508 W Archer Ave
Suite 3
Chicago, IL 60638-2424
Phone (773) 586-2220

Hospital & facility affiliations

  • Compmed Home Health, Inc Home health agency, Des Plaines, IL, CCN 147780
  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036095320ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chest Medicine Consultants, SC Past Accepting new patients

Organizations & group practices 1

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 5

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1598847873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 W ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60638",
            "telephone_number": "773-586-2220",
            "fax_number": "773-586-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 W ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60638",
            "telephone_number": "773-586-2220",
            "fax_number": "773-586-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKOL",
        "first_name": "CEZARY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095320",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.