Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1215499249 Individual Practitioner Female Practitioner

Dr. Jacquelyn Michelle Kukulski , DO

Pediatrics • Munster, IN

Professional Overview & Biography Verified Profile Summary

Dr. Jacquelyn Kukulski, DO is a registered healthcare professional specializing in Pediatrics in Munster, IN. Practice services are available at 10240 CALUMET AVE FL 2 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

10240 Calumet Ave Fl 2

Munster, IN 463214082

Telephone 2199229150
Fax 2199229180
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Munster, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 35.0 Yrs
State Avg: 19.8 Yrs
Regional Practice Density
19 Specialists

Practicing in Munster, IN (1179 Statewide)

Telehealth Adoption Rate
5.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-04-22
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IN 02007548A

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License IL 125.074969

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License IL 036.157681

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
300083601 (IN)
Medicaid State Provider ID
390200000X (IL)
Commercial Insurance / Payer ID Anthem
1103769274 (IN)

Secondary Practice Locations

5841 S Maryland Ave

Chicago, IL 606371443

Phone: 8888240200

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1013166115

NURSEPRACTIONER

NPI 1356461735

PYSCHCOUNSLEOR

Kari Klisurich

Nurse Practitioner - Family

NPI 1568015592
Nicole Bland , CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1780012583

CPNPPC

NPI 1912048851

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location December 30, 2024

Registered at 10240 CALUMET AVE FL 2, MUNSTER, IN 463214082 (Tel: 2199229150)

📍
Updated Business Mailing Address December 30, 2024

Registered at 8558 BROADWAY, MERRILLVILLE, IN 464107032 (Tel: 2193927084)

📍
Updated Practice Location August 05, 2022

Registered at 3100 SW 62ND AVE, MIAMI, FL 331553009 (Tel: 3056666511)

📍
Updated Business Mailing Address August 05, 2022

Registered at 3100 SW 62ND AVE, MIAMI, FL 331553009 (Tel: 3056666511)

📍
Updated Business Mailing Address November 30, 2020

Registered at 4440 W 95TH ST, OAK LAWN, IL 604532600 (Tel: 6304401388)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 14, 2019

Pediatrics (License #125.074969 in IL)

👤
Provider Name / Credentials Updated May 24, 2019

Recorded as JACQUELYN KUKULSKI, DO

NPI Profile Active April 01, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location April 01, 2019

Registered at 4440 W 95TH ST, OAK LAWN, IL 604532600 (Tel: 7086848000)

📍
Updated Business Mailing Address April 01, 2019

Registered at 1952 N HUMBOLDT BLVD APT 306, CHICAGO, IL 606473844 (Tel: 6304401388)

👤
Provider Name / Credentials Updated April 01, 2019

Recorded as JACQUELYN KUKULSKI, STUDENT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 01, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 01, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215499249
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 01, 2019
Last Update: April 22, 2025
Sole Proprietor: No

Mailing Address

8558 Broadway

Merrillville, IN 464107032

Phone: 2193927084

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.