DR. ELIZABETH ANNE POTOCNIK M.D.
NPI 1669867313
Obstetrics & Gynecology in Downers Grove, IL

NPI Status: Active since March 31, 2015

Contact Information

3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL
ZIP 60515
Phone: (630) 435-6107
Fax: (630) 435-6134

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  • Individual
  • Female
  • Years of Experience 11
  • Obstetrics & Gynecology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ELIZABETH POTOCNIK

This page provides the complete NPI Profile along with additional information for Elizabeth Potocnik, a women's health care provider established in Downers Grove, Illinois with a medical specialization in Obstetrics & Gynecology and more than 11 years of experience. She graduated from University Of Toledo College Of Medicine in 2015. The healthcare provider is registered in the NPI registry with number 1669867313 assigned on March 2015. The practitioner's primary taxonomy code is 207V00000X with license number 036-160985 (IL). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1669867313
Provider Name
DR. ELIZABETH ANNE POTOCNIK M.D.
Gender
Female
Entity Type
Individual
Location Address
3825 HIGHLAND AVE STE 210 DOWNERS GROVE, IL 60515
Location Phone
(630) 435-6107
Location Fax
(630) 435-6134
Mailing Address
PO BOX 713260 CHICAGO, IL 60677
Mailing Phone
(630) 469-9200
Medical School Name
UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Graduation Year
2015
Is Sole Proprietor?
No
Enumeration Date
03-31-2015
Last Update Date
08-17-2023
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Women's health care providers like Elizabeth Potocnik treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
036-160985
License State
IL
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207V00000XAllopathic & Osteopathic Physicians

Obstetrics & Gynecology

35135702 (OH)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Silver 6000 $20 Generic Drugs - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0358100MEDICAID (05)OH 

Medicare Participation & PECOS Enrollment Status

Elizabeth Potocnik is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Elizabeth Potocnik is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4587972062

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20220912002094

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $34.35 for a new patient copayment and $18.59 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 60515 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $137.43
  • Minimum New Patient Price $59.81
  • Maximum New Patient Price $181.38
  • Average New Patient Copayment $34.35
  • Minimum New Patient Copayment $14.95
  • Maximum New Patient Copayment $45.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $74.38
  • Minimum Established Patient Price $19.15
  • Maximum Established Patient Price $147.12
  • Average Established Patient Copayment $18.59
  • Minimum Established Patient Copayment $4.78
  • Maximum Established Patient Copayment $36.78

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1669867313, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
6
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
3
Unchanged
Pos 9
1
Doubled → 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 8 → 16 → 7 7 → 14 → 5 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 1 + 6 + 6 + 1 + 4 + 3 + 2 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1669867313.

Other Providers at the Same Location


The following 11 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Physician Assistant
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Nurse Practitioner
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Physician Assistant
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Internal Medicine (Nephrology)
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Obstetrics & Gynecology
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Hospitalist
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Obstetrics & Gynecology
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Hospitalist
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Nurse Practitioner
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515
Internal Medicine (Nephrology)
3825 HIGHLAND AVE STE 210
DOWNERS GROVE, IL 60515

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669867313, enumerated as an "individual" on March 31, 2015.

The provider is located at 3825 HIGHLAND AVE STE 210 DOWNERS GROVE, IL 60515 and the phone number is (630) 435-6107.

Obstetrics & Gynecology with taxonomy code 207V00000X.

The provider might be accepting Accepts: CareSource, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.