Individual provider Active NPI

Mark Kurzatkowski, PHARM.D.

  • Pharmacist
  • Park Ridge, IL
National Provider Identifier
1881976017
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.292621 Issued in IL
Practice address
800 Devon Ave
Park Ridge, IL 60068-4760
Phone
(847) 825-7194
Fax
(847) 825-7205
NPI assigned
Sep 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.292621 IL Primary

Addresses

Primary practice location

800 Devon Ave
Park Ridge, IL 60068-4760

Mailing address

800 Devon Ave
Park Ridge, IL 60068-4760
Phone (847) 825-7194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051.292621ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1881976017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 DEVON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684760",
            "telephone_number": "847-825-7194",
            "fax_number": "847-825-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 DEVON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684760",
            "telephone_number": "847-825-7194",
            "fax_number": "847-825-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURZATKOWSKI",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.292621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.