Lisa Kozinski, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036112489 Issued in IL

Practice address

5425 W Lake St
Chicago, IL 60644-2342

Phone

(773) 378-3347

Fax

(773) 378-4028

NPI assigned

Nov 18, 2005

Last updated

Dec 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Family Practice

Education

Rush Medical College of Rush University, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Suburban Medical Center Hospital, Oak Park, IL, CCN 140049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.kozinski.1@13158.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment Care Compare group NPD
• PCC Community Wellness Center

  dba PCC Austin Dental & Specialty Care Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• Gottlieb Community Health Services Corporation

  • General Acute Care Hospital
  • Berwyn, IL
  • NPI 1043292428
  NPD (past)
• PCC Community Wellness Center

  dba PCC Austin Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1609892223
  NPD (past)

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

• Resilience Healthcare-West Suburban Medical Center, LLC

  dba West Suburban Medical Center

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1619442266
  Care Compare affiliation

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1871575233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W LAKE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606442342",
            "telephone_number": "773-378-3347",
            "fax_number": "773-378-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W LAKE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606442342",
            "telephone_number": "773-378-3347",
            "fax_number": "773-378-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 N Humphrey Ave",
            "address_2": "unit 2N",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022579",
            "country_code": "US",
            "telephone_number": "708-445-7579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZINSKI",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036112489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112489",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kailee Ann Kozicki
• Kevin John Kozie, DPM
• Joanna Kozien, PHARMD
• Kenneth Milan Kozik, D.D.S
• Walter John Kozin, D.D.S.
• Jaclyn F. Koziol, PA-C
• Jakub Koziol
• Katarzyna Anna Koziol, APN-CNP
• Sophia Koziol, DO
• Wioleta Koziol, LCSW

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.