Marian Kowalczyk, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-101289 Issued in IL

Practice address

3115 N Harlem Ave
Ste 202
Chicago, IL 60634-4683

Phone

(773) 282-4793

Fax

(773) 282-4844

NPI assigned

Jul 23, 2006

Last updated

Jan 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1740201664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 EDGEMONT LN",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682155",
            "telephone_number": "773-282-4793",
            "fax_number": "773-282-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 N HARLEM AVE",
            "address_2": "STE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344683",
            "telephone_number": "773-282-4793",
            "fax_number": "773-282-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "MARIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-101289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101289",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beata Zosia Kowalczyk Budziakowska, MD
• Andrew Matthew Kowalczyk, APRN
• David Michael Kowalczyk, M.D., M.B.A.
• Hannah Kowalczyk
• Karolina Kowalczyk, L.C.S.W.
• Martha Jeanne Kowalczyk, PHD
• Nicholas S Kowalczyk, MD
• Brittany Alexis Kowalik, MS, DT
• Alex Kowalski, PHARM,D.
• Crystal Kowalski, LPC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.