Individual provider Active NPI

Amy Beth Kutska, PA-C

  • Physician Assistant
  • Palos Heights, IL
National Provider Identifier
1790320802
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.007278 Issued in IL
Practice address
12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone
(708) 923-4200
Fax
(708) 923-4201
NPI assigned
Nov 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.007278 IL Primary

Addresses

Primary practice location

12251 S 80TH Ave
Palos Heights, IL 60463-1290

Mailing address

12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone (708) 923-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200213002631 IL Practitioner - Physician Assistant 5799111514 Reassigns benefits to 3 organizations
I20240311002997 CO Practitioner - Physician Assistant 5799111514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians
Annest Synn Nowak and Mubarak Professional LLCGroup PAC ID 8921909755, 11 clinicians

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500

1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

12251 S 80TH Ave
Palos Heights, IL 60463-1290

21202 Owens Rd
Suite 101
Mokena, IL 60448-2001
Phone (630) 315-6930

310 County Rd
Suite 14
Del Norte, CO 81132-8758
Phone (719) 657-2510

3970 Youngfield St
Wheat Ridge, CO 80033-3865
Phone (303) 539-0736

4105 E Florida Ave
Denver, CO 80222-3641
Phone (303) 539-0736

600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • HCA HealthOne Presbyterian St. Lukes Hospital, Denver, CO, CCN 060014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.007278ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Illinois, LLP CurrentSince Mar 21, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 3, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 3, 2025 Accepting new patients
Cepamerica Illinois LLP CurrentSince Mar 21, 2022 Accepting new patients
Christie Clinic, PLLC CurrentSince Jan 24, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Dept 5777
Carol Stream, IL 60122

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

12251 S 80th Ave
Ste 1520
Palos Heights, IL 60463
Phone (708) 923-3936

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1790320802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631290",
            "telephone_number": "708-923-4200",
            "fax_number": "708-923-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631290",
            "telephone_number": "708-923-4200",
            "fax_number": "708-923-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTSKA",
        "first_name": "AMY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.