Individual provider Active NPI

Maciej Richard Kozlowski, DPT, PT

  • Physical Therapist
  • Algonquin, IL
National Provider Identifier
1174296396
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070025967 Issued in IL
Practice address
3973 W Algonquin Rd
Algonquin, IL 60102-9700
Phone
(224) 348-7600
NPI assigned
Jul 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 070.025967 IL
Physical Therapist 225100000X 070025967 IL Primary

Addresses

Primary practice location

3973 W Algonquin Rd
Algonquin, IL 60102-9700

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210812000254 IL Practitioner - Physical Therapist in Private Practice 5597169508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Rehabilitation Services LLCGroup PAC ID 2264479518, 569 clinicians

Practice addresses (Care Compare)

3973 W Algonquin Rd
Algonquin, IL 60102-9700
Phone (586) 350-2644

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
87.86
Improvement activities
40
Cost
61.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070025967ILMDPhysical Therapist
070.025967ILMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 22, 2021 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 22, 2021 Accepting new patients

Locations

3973 W Algonquin Rd
Algonquin, IL 60102
Phone (224) 348-7600

10801 S Western Ave
Chicago, IL 60643
Phone (773) 445-4200

9 N 2nd St
St Charles, IL 60174
Phone (630) 526-4200

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

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.

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1174296396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3973 W ALGONQUIN RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601029700",
            "telephone_number": "224-348-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "MACIEJ",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070.025967",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070025967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.