Ella Komarovsky, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036106106 Issued in IL

Practice address

1000 Central St
Evanston, IL 60201-1777

Phone

(847) 425-6400

NPI assigned

Jul 28, 2005

Last updated

Jul 21, 2022By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912907247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 W SALT CREEK LN",
            "address_2": "SUITE 114",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055023",
            "telephone_number": "847-952-7460",
            "fax_number": "847-222-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011777",
            "telephone_number": "847-425-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMAROVSKY",
        "first_name": "ELLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036106106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036106106",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "363045007",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Kolbuck
• Sharona Kolesnikov
• Samantha Valentine Kolkey, LCSW
• Terrence James Koller, PH.D.
• Ludmila Kolomay, FNP
• Madhuri V Konanahalli, M.D.
• Athanasios Kondilis, DO/PHD
• Dalia Esmeralda Koo
• Wendy Kopald, LCSW
• Shannon Lynn Kopecky, CRNA

• Psychiatry Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.