DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) – Pediatric Surgery Physician, NPI 1639481476

DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) is a healthcare provider. based in Park ridge, Illinois. specializing in Pediatric Surgery Physician. They hold the professional credentials MD, MPH. They hold a License No. 036-162303 (IL). The NPI Number for DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) is 1639481476

Main info

Female
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH)
NPI
1639481476
Phone
(773) 702-6175
Address
1675 Dempster St Fl 3
Enumeration Date
9 July 2010
Last Update Date
2 February 2023

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2010 (16 years ago)
PAC ID
8325347545
Group Practice PAC ID
3375701568
Professional Enrollment ID
I20200615002437

Contacts

Secure Messaging
ckvasnosky353667@direct.myadvocateaurora.org
FHIR Endpoint
https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:15State licenses:1Other namesUpdated within 12 months

Provider Addresses for DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH)

  • 1675 Dempster St Fl 3

    Park Ridge, IL 600681110

    Phone: (773) 702-6175

    Fax: (847) 723-5615

    Type: Location

  • 827 SAINT PAUL ST

    FLOOR 4

    BALTIMORE, MD 212022405

    Phone: (240) 383-2157

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $36.

Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: KLS-Martin L.P. ($36).

Total Amount

$36

General + Research + Ownership

Payments

1

Total payment records

General Amount

$36

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
KLS-Martin L.P.$36
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-12-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221202002879IPediatric MedicineILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60068)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375701568View full group profile
NameSpecialtyState
General Surgery, Critical Care (Intensivists)NY
Diagnostic RadiologyNY
-NY
Hospitalist, Family PracticeNY
-NY
Infectious DiseaseNC
-NY
-NY
Cardiac Surgery, Vascular SurgeryNY
-CA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH)?
DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) — NPI 1639481476 — is the standard way to identify this listing.
Does the file indicate DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) is practicing under active NPI?
Directory data currently reports DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) as active.
What healthcare role does DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) hold?
Scheduling teams often label DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) under Pediatric Surgery Physician. Clinical services aligned with this taxonomy classification.
Does DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) list a practice location?
Patients near Park Ridge, Illinois may find DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) in results; validate coverage separately.
Why does DR. CHARLOTTE LOUISE KVASNOVSKY (MD, MPH) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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