Active NPI
Iwona Laciak, P.T.
- Physical Therapist
- Homer Glen, IL
National Provider Identifier
1093983751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070007510
- Practice address
- 14330 S Will Cook Rd
Homer Glen, IL 60491-9211 - Phone
- (708) 645-0288
- Fax
- (708) 349-7430
- NPI assigned
- Feb 15, 2008
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070007510 | IL | Primary |
Addresses
Primary practice location
14330 S Will Cook Rd
Homer Glen, IL 60491-9211
Mailing address
90 Rose CT
Lemont, IL 60439-7404
Phone (630) 699-4839
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070007510 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J.E.Bertolini ,M.D. SC. | Past | Accepting new patients | |
| J.E. Bertolini MD, S.C. | Past | Accepting new patients |
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.
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- Non-Pharmacy Dispensing Site
- Joliet, IL
- NPI 1245513076
-
- Orthopaedic Surgery Physician
- Joliet, IL
- NPI 1477726610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425254400000",
"number": "1093983751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 ROSE CT",
"city": "LEMONT",
"state": "IL",
"postal_code": "604397404",
"telephone_number": "630-699-4839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14330 S WILL COOK RD",
"city": "HOMER GLEN",
"state": "IL",
"postal_code": "604919211",
"telephone_number": "708-645-0288",
"fax_number": "708-349-7430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACIAK",
"first_name": "IWONA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-15",
"last_updated": "2015-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070007510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homer Glen, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.