Kristi Lyn Kozlov, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036103302 Issued in IL

Practice address

3100 Ogden Ave
Lisle, IL 60532-1603

Phone

(630) 527-1920

Fax

(630) 527-0125

NPI assigned

Dec 14, 2006

Sex

Female

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

Specialty

Ophthalmology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Reenvision Eyecare, S.C.

  • Cornea and External Diseases Specialist Physician
  • Buffalo Grove, IL
  • NPI 1386311900
  Medicare reassignment Authorized official
• Simpson Eye Associates LTD

  • Ophthalmology Physician
  • Crystal Lake, IL
  • NPI 1851348601
  Medicare reassignment
• Simpson Eye Associates LTD

  • Ophthalmology Physician
  • Hoffman Estates, IL
  • NPI 1235376021
  NPD
• Lakeshore Eye Physicians and Surgeons SC

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1548275985
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1750443073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SPRING HILL RING RD",
            "address_2": "STE 2020",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601181297",
            "telephone_number": "312-771-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OGDEN AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321603",
            "telephone_number": "630-527-1920",
            "fax_number": "630-527-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOV",
        "first_name": "KRISTI",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "LLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036103302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02233058",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isabella Rae Koenig, ATC
• Victoria Koenig
• Janina Kojak, PT
• Nadezhda O Komarova, APN
• Joseph John Kosar Jr., D.N.
• Aaron N Kraai, DPT
• Paul Kreinbrink, M.D.
• Julia Kribs, DC
• Krisiti Kozlov
• Joshua Otto Krohse, PA

• Ophthalmology Physician in Lisle, IL
• Providers in Lisle, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.