Individual provider Active NPI

Anna Maria Koziel, APRN, FNP-C

  • Family Nurse Practitioner
  • Willowbrook, IL
National Provider Identifier
1851986624
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209022954 Issued in IL
Practice address
40 75TH St
Willowbrook, IL 60527-2325
Phone
(630) 405-8892
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209022954 IL Primary

Addresses

Primary practice location

40 75TH St
Willowbrook, IL 60527-2325

Mailing address

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 405-8892

Other practice location 1

15050 Allison Ln
Homer Glen, IL 60491-8373
Phone (708) 691-7203

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
I20210713002091 IL Practitioner - Nurse Practitioner 0648672683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Jun 15, 2021 Accepting new patients
Emergency Medical Associates of Palos, LTD. CurrentSince Apr 1, 2023 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jun 15, 2021 Accepting new patients

Locations

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

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

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1851986624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 75TH ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272325",
            "telephone_number": "630-405-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 75TH ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272325",
            "telephone_number": "630-405-8892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15050 Allison Ln",
            "address_purpose": "LOCATION",
            "city": "Homer Glen",
            "state": "IL",
            "postal_code": "604918373",
            "country_code": "US",
            "telephone_number": "708-691-7203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZIEL",
        "first_name": "ANNA",
        "middle_name": "MARIA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

Verify at the official NPI Registry.