Individual provider Active NPI

Beata Kosycarz, PTA

  • Physical Therapy Assistant
  • Chicago, IL
National Provider Identifier
1083071997
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.001677 Issued in IL
Practice address
5831 N Northwest Hwy
Chicago, IL 60631-2642
Phone
(773) 775-8080
Fax
(773) 775-9672
NPI assigned
Jan 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.001677 IL Primary

Addresses

Primary practice location

5831 N Northwest Hwy
Chicago, IL 60631-2642

Mailing address

5831 N Northwest Hwy
Chicago, IL 60631-2642
Phone (773) 775-8080

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

State licenses

LicenseStateTypeSpecialty
160.001677ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1083071997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312642",
            "telephone_number": "773-775-8080",
            "fax_number": "773-775-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5831 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312642",
            "telephone_number": "773-775-8080",
            "fax_number": "773-775-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSYCARZ",
        "first_name": "BEATA",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.001677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.