Agnieszka Agata Grochowska, DEVELOPMENTAL THERAP

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

AG47341000P Issued in IL

Practice address

424 Thunder RDG
Lake in the Hills, IL 60156-4827

Phone

(773) 895-1367

Fax

(847) 658-3080

NPI assigned

Apr 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Agnieszka Grochowska DT Inc

  • Early Intervention Provider Agency
  • Lake in the Hills, IL
  • NPI 1881865517
  NPD (past) Authorized official

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407978810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 THUNDER RDG",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601564827",
            "telephone_number": "773-895-1367",
            "fax_number": "847-658-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 THUNDER RDG",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601564827",
            "telephone_number": "773-895-1367",
            "fax_number": "847-658-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCHOWSKA",
        "first_name": "AGNIESZKA",
        "middle_name": "AGATA",
        "credential": "DEVELOPMENTAL THERAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "AG47341000P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Therapist in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Developmental Therapist in Illinois

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.