Active NPI
Andrew M Kawecki, M.D.
- General Practice Physician
- Niles, IL
National Provider Identifier
1972715167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 036-104016 | IL | MD | General 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.