Ronald K Potkul, MD

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

License

36065084 Issued in IL

Practice address

2160 S First Ave
Cardinal Bernadin Cancer Center
Maywood, IL 60153

Phone

(708) 216-8563

Fax

(708) 216-2186

NPI assigned

Feb 15, 2006

Last updated

Nov 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Gynecological OncologyAlso: Obstetrics/Gynecology

Education

University of Chicago, Pritzker School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
• Edward Hospital Hospital, Naperville, IL, CCN 140231
• Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008
• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
• Macneal Hospital Hospital, Berwyn, IL, CCN 140054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  dba Mulcahy Pharmacy

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Loyola University Physician Foundation

  • General Practice Physician
  • Maywood, IL
  • NPI 1235148891
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward Hospital

  dba Endeavor Health Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1427069632
  Care Compare affiliation
• Elmhurst Memorial Hospital

  dba Endeavor Health Elmhurst Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation
• Gottlieb Community Health Services Corporation

  dba MacNeal Hospital

  • General Acute Care Hospital
  • Berwyn, IL
  • NPI 1295710580
  Care Compare affiliation
• Gottlieb Memorial Hospital

  • General Acute Care Hospital
  • Melrose Park, IL
  • NPI 1831170232
  Care Compare affiliation
• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  dba Loyola University Medical Center Cancer Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1619941523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-8563",
            "fax_number": "708-216-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "CARDINAL BERNADIN CANCER CENTER",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-8563",
            "fax_number": "708-216-2186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2216 W Thomas St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606223778",
            "country_code": "US",
            "telephone_number": "312-770-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTKUL",
        "first_name": "RONALD",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036065084",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "IL",
            "license": "36065084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpotkul11586@direct.luhs.org",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S First Ave",
            "address_2": "CARDINAL BERNADIN CANCER CENTER",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Theodote K. Pontikes, M.D.
• Shirin Amlani Poonja, D.O
• Nancy L Porter, APN
• Shaun Porter
• Joshua Jeremy Pothen, MD
• Vamsi Krishna Potluri, MD
• Victoria Marie Pouille
• Darrell C Powe, M.D.
• Brian Powell
• Carson Powell, MD

• Gynecologic Oncology Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Gynecologic Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.