Individual provider Active NPI

Andrew M Kawecki, M.D.

  • General Practice Physician
  • Niles, IL
National Provider Identifier
1972715167
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Practice address
8647 N Ozanam Ave
Niles, IL 60714-1925
Phone
(847) 983-8603
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X IL Primary

Addresses

Primary practice location

8647 N Ozanam Ave
Niles, IL 60714-1925

Mailing address

8647 N Ozanam Ave
Niles, IL 60714-1925
Phone (847) 983-8603

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-104016ILMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1972715167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8647 N OZANAM AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141925",
            "telephone_number": "847-983-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8647 N OZANAM AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141925",
            "telephone_number": "847-983-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWECKI",
        "first_name": "ANDREW",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.