Logan N Nierzwicki, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070022504 Issued in IL

Practice address

7341 A Lake St
River Forest, IL 60305

Phone

(708) 763-0564

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Logan N Bartz Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: logan.nierzwicki.1@9398.direct.athenahealth.com

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.

• Athletico LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028
  Medicare reassignment

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1063969004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7341 A LAKE ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "60305",
            "telephone_number": "708-763-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERZWICKI",
        "first_name": "LOGAN",
        "middle_name": "N",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070022504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOGAN",
            "last_name": "BARTZ",
            "middle_name": "N",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Alex Munaretto, D.D.S
• John Edward Mundt, PH.D.
• Brittany Ann Muriello
• Denise Christine Murmann, DDS
• Erik M Myers, DPT
• James A Nugent, DC
• Elizabeth Robin Nye, M.D.
• Mary Ann Gaby O'Connell, M.A.
• Oak Park Cardiology, S.C.
• Ann Shannon Oconnell, LCSW

• Physical Therapist in River Forest, IL
• Providers in River Forest, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.