Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Katarzyna B Iwanicki, PA

Individual provider Physician Assistant · NPI 1760532790

Katarzyna B Iwanicki, PA is a Physician Assistant in Mount Prospect, Illinois. Qualified in 2005, 21 years ago. Practices with Ear Nose and Throat Family Clinic of Wisconsin SC, a 12-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
21
Licensed in
IL
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

250 W Kensington Rd Ste 3B
Mount Prospect, IL 60056-1292
Phone: (622) 652-2887
Fax: (262) 764-0224
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-002648 (IL)

Record details

NPI number1760532790
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 11, 2007
Last updated in NPPESSeptember 3, 2021
Certification dateSeptember 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Ear Nose And Throat Family Clinic Of Wisconsin Sc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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