Active NPI
Zuzanna Koscielniak
- Behavior Technician
- Chicago, IL
National Provider Identifier
1083230874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5123 S Laporte Ave
Chicago, IL 60638-3010 - Phone
- (773) 615-0797
- NPI assigned
- Jun 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | IL | Primary |
Addresses
Primary practice location
5123 S Laporte Ave
Chicago, IL 60638-3010
Mailing address
5123 S Laporte Ave
Chicago, IL 60638-3010
Phone (773) 615-0797
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 177742020 | Medicaid | IL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592352000000",
"number": "1083230874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5123 S LAPORTE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606383010",
"telephone_number": "773-615-0797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5123 S LAPORTE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606383010",
"telephone_number": "773-615-0797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSCIELNIAK",
"first_name": "ZUZANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-17",
"last_updated": "2020-06-17",
"certification_date": "2020-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "177742020",
"state": "IL"
}
],
"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 Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.