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

Mariola Kaczkowski

Individual provider Nurse Practitioner · NPI 1861796724

Mariola Kaczkowski is a Nurse Practitioner in Park Ridge, Illinois. Qualified in 2010, 16 years ago. Practices with Endeavor Health Medical Group, a 3,348-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
16
Licensed in
IL
In the registry since
2011
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Practice location Address checks out

1875 Dempster St Ste 180
Park Ridge, IL 60068-1186
Phone: (847) 825-0800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209008582 (IL)

Record details

NPI number1861796724
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 6, 2011
Last updated in NPPESJanuary 6, 2011
Mailing addressPo Box 2056, Northbrook, IL 60065-2056

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Endeavor Health Medical Group — 3348 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Park Ridge