Individual provider Active NPI

Kathleen Josephine Slugocki, D.O.

  • Obstetrics & Gynecology Physician
  • Mokena, IL
National Provider Identifier
1619157526
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036120113 Issued in IL
Practice address
10260 191St St
Ste 100
Mokena, IL 60448-8801
Phone
(708) 425-1907
Fax
(708) 469-4358
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036120113 IL Primary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 89987440 IL

Addresses

Primary practice location

10260 191St St
Ste 100
Mokena, IL 60448-8801

Mailing address

10260 191St St
Ste 100
Mokena, IL 60448-8801
Phone (708) 425-1907

Other practice location 1

9730 S Western Ave Ste 700
Evergreen Park, IL 60805-2814
Phone (708) 425-1907

Other identifiers 1

IdentifierTypeStateIssuer
036120113MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address whc@providea.gwaydirect.com Direct

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
I20080616000613 IL Practitioner - Obstetrics/Gynecology 5294811378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providea Health Partners LLCGroup PAC ID 5698904878, 7 clinicians

Practice addresses (Care Compare)

10260 191St St
Suite 100
Mokena, IL 60448-8802
Phone (708) 572-7606

9730 S Western Ave
Suite 700
Evergreen Park, IL 60805-2814
Phone (708) 425-1907

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89987440ILMDObesity Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A Lota Healthcare LTD Obstetrics & Gynecology CurrentSince Jan 26, 2022 Accepting new patients

Locations

9730 S Western Ave
Ste 700
Evergreen Pk, IL 60805
Phone (708) 425-1907

10260 191st St
Ste 100
Mokena, IL 60448
Phone (708) 425-1907

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1619157526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 191ST ST",
            "address_2": "STE 100",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488801",
            "telephone_number": "708-425-1907",
            "fax_number": "708-469-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10260 191ST ST",
            "address_2": "STE 100",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488801",
            "telephone_number": "708-425-1907",
            "fax_number": "708-469-4358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9730 S Western Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052814",
            "country_code": "US",
            "telephone_number": "708-425-1907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLUGOCKI",
        "first_name": "KATHLEEN",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036120113",
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "IL",
            "license": "89987440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120113",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whc@providea.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "EHR secure mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR secure mail",
            "address_1": "10260 191st St",
            "address_2": "Ste 100",
            "city": "Mokena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604488801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.