Individual provider Active NPI

Joseph George Bozic, LMFT

  • Marriage & Family Therapist
  • Crystal Lake, IL
National Provider Identifier
1063769354
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166000972 Issued in IL
Practice address
457 Coventry LN Ste 118
Crystal Lake, IL 60014-7571
Phone
(815) 444-9210
NPI assigned
Aug 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166000972 IL Primary
Marriage & Family Therapist 106H00000X 208000264 IL

Addresses

Primary practice location

457 Coventry LN Ste 118
Crystal Lake, IL 60014-7571

Mailing address

1410 Grandview CT
Algonquin, IL 60102-1995
Phone (847) 845-7953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124001333 IL Practitioner - Marriage and Family Therapist 3577927342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

457 Coventry LN
Suite 118
Crystal Lake, IL 60014-7571
Phone (847) 845-7953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
208000264ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Bozic Therapy, LLC Marriage & Family Therapist CurrentSince Aug 29, 2023 Accepting new patients
Kenneth Gates and Associates Past Accepting new patients

Locations

457 Coventry Ln
Ste 118
Crystal Lake, IL 60014
Phone (815) 459-5433

8600 US Highway 14
Ste 110
Crystal Lake, IL 60012
Phone (815) 444-9210

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1063769354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 GRANDVIEW CT",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601021995",
            "telephone_number": "847-845-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 COVENTRY LN STE 118",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147571",
            "telephone_number": "815-444-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZIC",
        "first_name": "JOSEPH",
        "middle_name": "GEORGE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-06",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000972",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208000264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.