Individual provider Active NPI

Natalie Kozlov, MD

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1619127339
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036129976 Issued in IL
Practice address
251 E Huron St
Feinberg 5-704
Chicago, IL 60611-2908
Phone
(312) 695-0061
Fax
(312) 695-9013
NPI assigned
Sep 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125051411 IL
Anesthesiology Physician 207L00000X 56290 WI
Anesthesiology Physician 207L00000X 036129976 IL Primary

Addresses

Primary practice location

251 E Huron St
Feinberg 5-704
Chicago, IL 60611-2908

Mailing address

251 E Huron St
Feinberg 5-704
Chicago, IL 60611-2908
Phone (312) 695-0061

Other identifiers 1

IdentifierTypeStateIssuer
1619127339MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
036129976ILMDAnesthesiology Physician
125051411ILMDAnesthesiology Physician
56290WIMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1619127339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "address_2": "FEINBERG 5-704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-695-0061",
            "fax_number": "312-695-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "address_2": "FEINBERG 5-704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-695-0061",
            "fax_number": "312-695-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOV",
        "first_name": "NATALIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125051411",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "56290",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036129976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619127339",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.