Individual provider Active NPI

Addison James Korzun, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1831409069
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005938 Issued in IL
Practice address
675 N Saint Clair St
Ste 20-250
Chicago, IL 60611-5975
Phone
(312) 695-8143
NPI assigned
Oct 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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 085005938 IL Primary

Addresses

Primary practice location

675 N Saint Clair St
Ste 20-250
Chicago, IL 60611-5975

Mailing address

680 N Lake Shore Dr
Chicago, IL 60611-4546
Phone (312) 695-9797

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170608000021 IL Practitioner - Physician Assistant 8325227846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

680 N Lake Shire Dr
Suite 1000
Chicago, IL 60611-8709

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2017 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

680 N Lake Shore Dr
Chicago, IL 60611
Phone (312) 503-6000

675 N Saint Clair St
Ste 20-250
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 2

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 2

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": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1831409069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST",
            "address_2": "STE 20-250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORZUN",
        "first_name": "ADDISON",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-21",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.