Ksenia Mack, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.027296 Issued in IL

Practice address

4657 N Lincoln Ave
Chicago, IL 60625-2024

Phone

(773) 989-6472

NPI assigned

Feb 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

LSF PT LLCGroup PAC ID 5890953483, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• LSF PT LLC

  dba Lakeshore Physical Therapy

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1629347992

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Rci (WRS), LLC.

  dba RUSH Physical Therapy

  • Physical Therapy Clinic/Center
  • Mount Prospect, IL
  • NPI 1417561655

  Physical Therapist

  Medicare reassignment NPD
• Rci (WRS), LLC

  • Physical Therapy Clinic/Center
  • Mokena, IL
  • NPI 1568160950
  NPD
• Rci (WRS), LLC.

  dba RUSH Physical Therapy

  • Rehabilitation Clinic/Center
  • Chicago, IL
  • NPI 1871107037
  NPD

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1033817747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 N BURLING ST APT 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144434",
            "telephone_number": "847-420-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4657 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252024",
            "telephone_number": "773-989-6472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Fullerton Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606142129",
            "country_code": "US",
            "telephone_number": "773-770-2419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "KSENIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.027296",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayna M Mack
• Elaine Mack, L.AC
• Erica Mack, LSW
• Jasmine Ginger Mack
• Kaela Mack
• Lara Mack, PA-C
• Laurin Jarrold Mack, PH.D.
• Mallory Mack
• Shale Mack, MD
• Derrick Anthony Mackavich, D.O.

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.