Individual provider Active NPI

Jacek Wolowski

  • Physical Therapist
  • Buffalo Grove, IL
National Provider Identifier
1154067908
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1567 Deerfield Pkwy
Buffalo Grove, IL 60089-2653
Phone
(847) 520-9038
NPI assigned
May 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1567 Deerfield Pkwy
Buffalo Grove, IL 60089-2653

Mailing address

1567 Deerfield Pkwy
Buffalo Grove, IL 60089-2653
Phone (847) 520-9038

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Rehabilitation Group Inc Physical Therapist CurrentSince May 8, 2022 Accepting new patients

Locations

1567 Deerfield Pkwy
Buffalo Grove, IL 60089
Phone (847) 520-9038

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1154067908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 DEERFIELD PKWY",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892653",
            "telephone_number": "847-520-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1567 DEERFIELD PKWY",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892653",
            "telephone_number": "847-520-9038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLOWSKI",
        "first_name": "JACEK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.