NPIMap

Individual provider Active NPI

Alex Kostiv, M.D.

  • Family Medicine Physician
  • Vernon Hills, IL
National Provider Identifier
1639317217
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.127007 Issued in IL
Practice address
565 Lakeview Pkwy
Suite 190
Vernon Hills, IL 60061-1857
Phone
(847) 549-3171
NPI assigned
Feb 4, 2009
Last updated
May 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2016

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 036.127007 IL Primary

Addresses

Primary practice location

565 Lakeview Pkwy
Suite 190
Vernon Hills, IL 60061-1857

Mailing address

PO Box 2056
Suite 190
Northbrook, IL 60065-2056
Phone (847) 858-7367

Other names 1

  • Oleksandr Kostiv Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110830000494 IL Practitioner - Family Practice 4183894157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kirill Zhadovich, M.D., S.C.Group PAC ID 3072545896, 4 clinicians

Practice addresses (Care Compare)

7900 N Milwaukee Ave
Suite 2 24
Niles, IL 60714-3186
Phone (847) 825-0800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.127007ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kirill Zhadovich, M.D., S.C. CurrentSince Dec 20, 2014 Accepting new patients

Locations

7900 N Milwaukee Ave
Ste 2-24
Niles, IL 60714
Phone (847) 626-1600

565 Lakeview Pkwy
Ste 190
Vernon Hills, IL 60061
Phone (847) 984-6490

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBGFBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1639317217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2056",
            "address_2": "SUITE 190",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600652056",
            "telephone_number": "847-858-7367",
            "fax_number": "847-825-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 LAKEVIEW PKWY",
            "address_2": "SUITE 190",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611857",
            "telephone_number": "847-549-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTIV",
        "first_name": "ALEX",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.127007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLEKSANDR",
            "last_name": "KOSTIV",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vernon Hills, IL

Sources for this page

Verify at the official NPI Registry.