Blade Morgan Kowalski

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160010187 Issued in IL

Practice address

2000 Lake Ave # 2
Woodstock, IL 60098-7401

Phone

(815) 337-7100

NPI assigned

Aug 8, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: bkowalski116115@direct.mhemail.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1023849494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9619 MARCI LN",
            "city": "HEBRON",
            "state": "IL",
            "postal_code": "600349513",
            "telephone_number": "815-528-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE # 2",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987401",
            "telephone_number": "815-337-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "BLADE",
        "middle_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160010187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katlyn Koskotas, APRN
• Shannon Kosmatka, PTA
• Cari Koss
• Grazyna Kostecki
• Brian Kostuk, D.O.
• Daniel George Krall, O.D.
• Karen Brenda Kreiner, MD
• Jaclyn Kroeger, LCSW
• Holly K Kronn, RN
• Janine A. Krueger, PHARM.D.

• Physical Therapy Assistant in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.