Martha Jeanne Kowalczyk, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009474 Issued in IL

Practice address

3042 N Kenmore Ave Apt 2S
Chicago, IL 60657-9674

Phone

(260) 402-4300

NPI assigned

May 16, 2023

Last updated

May 16, 2023By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

• Chicago Psychology Services , LLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1487120317
  Medicare reassignment

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1093406522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 N KENMORE AVE APT 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606579674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3042 N KENMORE AVE APT 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606579674",
            "telephone_number": "260-402-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "MARTHA",
        "middle_name": "JEANNE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Matthew Kowalczyk, APRN
• David Michael Kowalczyk, M.D., M.B.A.
• Hannah Kowalczyk
• Karolina Kowalczyk, L.C.S.W.
• Marian Kowalczyk, MD
• Nicholas S Kowalczyk, MD
• Brittany Alexis Kowalik, MS, DT
• Alex Kowalski, PHARM,D.
• Crystal Kowalski, LPC
• Danuta Kowalski, M.D.

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.