Pawel K Kwiecinski, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036069086 Issued in IL

Practice address

5356 W Diversey Ave
Chicago, IL 60639-1513

Phone

(773) 283-1881

Fax

(773) 283-2226

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 14, 2016 through Jan 14, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Pawel K Kwiecinski MD LTD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1124215223
  NPD (past) Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871647925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 MARDEN CT",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600623400",
            "telephone_number": "847-612-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5356 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391513",
            "telephone_number": "773-283-1881",
            "fax_number": "773-283-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIECINSKI",
        "first_name": "PAWEL",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036069086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1617311",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Kwasigroch, PHARMD, MBA
• Vishal Kwatra, MD
• Robert Nii Amaa Kwei-Nsoro
• Marianne Kwiatkowski, NP
• Martin Kwiatkowski, MD
• Amy Geary Kwilosz, LCSW
• Wan Kwok, MD
• Nicole Kwolek, APRN, CRNA
• Kwon Podiatric Services Incorporated
• Bora Kwon, APN-CNP

• 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 Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.