Individual provider Active NPI

Liborka Kos, M.D.

  • Pediatric Dermatology Physician
  • Wilmette, IL
National Provider Identifier
1679585210
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
036-114831 Issued in IL
Practice address
3232 Lake Ave
Wilmette, IL 60091-1073
Phone
(847) 318-9330
NPI assigned
Aug 12, 2006
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X 036-114831 IL Primary

Addresses

Primary practice location

3232 Lake Ave
Wilmette, IL 60091-1073

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lkos206597@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20070126000059 IL Practitioner - Pediatric MedicinePractitioner - Dermatology 4284661075 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-114831ILMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Dec 2, 2013 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Dec 2, 2013 Accepting new patients
Children's Hospital of Wisconsin Clinics-Vernon Hills Pediatric Dermatology Past Accepting new patients
Childrens Physician Group PC Pediatric Dermatology Past Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

565 Lakeview Pkwy
Ste 140
Vernon Hills, IL 60061
Phone (847) 247-5105

3232 Lake Ave
Wilmette, IL 60091
Phone (224) 266-9411

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1679585210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3232 LAKE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911073",
            "telephone_number": "847-318-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOS",
        "first_name": "LIBORKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "IL",
            "license": "036-114831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkos206597@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3232 Lake Ave",
            "city": "Wilmette",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600911073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3232 Lake Ave",
            "city": "Wilmette",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600911073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.