Active NPI
Austin Wielgosz
- Athletic Trainer
- Plainfield, IL
National Provider Identifier
1013638956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 12337 South, Illinois Route 59
Suite 119
Plainfield, IL 60585 - Phone
- (815) 267-6263
- NPI assigned
- Sep 8, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
12337 South, Illinois Route 59
Suite 119
Plainfield, IL 60585
Mailing address
24157 S Edwin Dr
Channahon, IL 60410-5210
Other practice location 1
24157 S Edwin Dr
Channahon, IL 60410-5210
Phone (815) 467-9395
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1013638956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24157 S EDWIN DR",
"city": "CHANNAHON",
"state": "IL",
"postal_code": "604105210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12337 SOUTH, ILLINOIS ROUTE 59",
"address_2": "SUITE 119",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "60585",
"telephone_number": "815-267-6263"
}
],
"practiceLocations": [
{
"address_1": "24157 S Edwin Dr",
"address_purpose": "LOCATION",
"city": "Channahon",
"state": "IL",
"postal_code": "604105210",
"country_code": "US",
"telephone_number": "815-467-9395",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIELGOSZ",
"first_name": "AUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-08",
"last_updated": "2022-09-08",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.