Andrew J Kontrick MDSC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

ANDREW J KONTRICK MDSC

Practice address

35 Tower Court
Suite I
Gurnee, IL 60031-5712

Phone

(847) 244-5884

Fax

(847) 244-0547

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Andrew J Kontrick, MD

Title

Owner Service Corporation

Phone

(847) 244-5884

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720154396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 TOWER COURT",
            "address_2": "SUITE I",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315712",
            "telephone_number": "847-244-5884",
            "fax_number": "847-244-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 TOWER COURT",
            "address_2": "SUITE I",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315712",
            "telephone_number": "847-244-5884",
            "fax_number": "847-244-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J KONTRICK MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KONTRICK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER SERVICE CORPORATION",
        "authorized_official_telephone_number": "847-244-5884",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04926221",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03604585865",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Andersen, LCSW
• John C Anderson
• Randa Mary Anderson, PH.D.
• Kaitlin Andler
• Amy Marie Andrea, PTA
• Deseree-Joy Angeles, RPT
• Angela Anton, APRN
• Nikolas J. Antoniou, M.D.
• Anwuli Okoli MD,Inc
• Apollo Dental Clinic, LLC

• All providers in Gurnee, IL
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.