Active NPI
Gregory Kaczmarek, MD, LLC
- Internal Medicine Physician
- Skokie, IL
National Provider Identifier
1780925305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036081697
- Legal business name
- GREGORY KACZMAREK, MD, LLC
- Practice address
- 4905 Old Orchard Ctr
Lower Level
Skokie, IL 60077-1458 - Phone
- (847) 679-6707
- NPI assigned
- Mar 6, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Gregory D Kaczmarek, M.D.
- Title
- President
- Phone
- (847) 679-6707
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036081697 | IL | Primary |
Addresses
Primary practice location
4905 Old Orchard Ctr
Lower Level
Skokie, IL 60077-1458
Mailing address
4905 Old Orchard Ctr
Lower Level
Skokie, IL 60077-1458
Phone (847) 679-6707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Gregory Kaczmarek MD LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Internal Medicine Physician
- Skokie, IL
- NPI 1770511339
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Skokie, IL
- NPI 1629032958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1362528000000",
"number": "1780925305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4905 OLD ORCHARD CTR",
"address_2": "LOWER LEVEL",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600771458",
"telephone_number": "847-679-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4905 OLD ORCHARD CTR",
"address_2": "LOWER LEVEL",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600771458",
"telephone_number": "847-679-6707"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREGORY KACZMAREK, MD, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-06",
"last_updated": "2013-03-06",
"status": "A",
"authorized_official_last_name": "KACZMAREK",
"authorized_official_first_name": "GREGORY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "847-679-6707",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "IL",
"license": "036081697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.