Individual provider Active NPI

Agata Kluz

  • Student in an Organized Health Care Education/Training Program
  • Arlington HTS, IL
National Provider Identifier
1922410018
Registry record updated May 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2770 S Cedar Glen Dr
Arlington HTS, IL 60005-5301
Phone
(847) 222-3553
NPI assigned
May 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2770 S Cedar Glen Dr
Arlington HTS, IL 60005-5301

Mailing address

2770 S Cedar Glen Dr
Arlington HTS, IL 60005-5301
Phone (847) 222-3553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160316000510 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6800192972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1922410018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 S CEDAR GLEN DR",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600055301",
            "telephone_number": "847-222-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 S CEDAR GLEN DR",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600055301",
            "telephone_number": "847-222-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUZ",
        "first_name": "AGATA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington HTS, IL

Sources for this page

Verify at the official NPI Registry.