Active NPI
Aaron Stachowiak
- Physical Medicine & Rehabilitation Physician
- Maywood, IL
National Provider Identifier
1275624736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 216-9000
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- 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 Medicine & Rehabilitation Physician | 208100000X | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
1508 N Harlem Ave
Apt 3E
River Forest, IL 60305-1226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130601000090 | IL | Order and Referring Only - Physical Medicine and Rehabilitation | 5597903625 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125049482 | IL | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275624736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 N HARLEM AVE",
"address_2": "APT 3E",
"city": "RIVER FOREST",
"state": "IL",
"postal_code": "603051226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACHOWIAK",
"first_name": "AARON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.