Individual provider Active NPI

Gustaw Janusz Kubiszewski, DPT

  • Physical Therapist
  • Buffalo Grove, IL
National Provider Identifier
1437255718
Registry record updated Aug 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014473 Issued in IL
Practice address
601 Deerfield Pkwy
Buffalo Grove, IL 60089-7500
Phone
(847) 215-0022
Fax
(847) 465-1663
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2017

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 070014473 IL Primary

Addresses

Primary practice location

601 Deerfield Pkwy
Buffalo Grove, IL 60089-7500

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071113000307 IL Practitioner - Physical Therapist in Private Practice 7517055353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1186 W Maple Ave
Mundelein, IL 60060-1438
Phone (847) 970-7099

1655 Nations Dr
Gurnee, IL 60031-9178
Phone (847) 782-9860

1870 E Grand Ave
Lindenhurst, IL 60046-7821
Phone (224) 643-0117

577 W Liberty St
Wauconda, IL 60084-2470
Phone (224) 993-0940

601 Deerfield Pkwy
Buffalo Grove, IL 60089-7500
Phone (847) 215-0022

722 N McLean Blvd
South Elgin, IL 60177-1429
Phone (847) 695-5088

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jul 11, 2016 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 11, 2016 Accepting new patients
Accucare Rehabilitation Center PC Physical Therapist Past Accepting new patients

Locations

1156 W Lake Cook Rd
Buffalo Grove, IL 60089
Phone (847) 498-1886

601 Deerfield Pkwy
Buffalo Grove, IL 60089
Phone (847) 215-0022

6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547

1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

300 S State St
Marengo, IL 60152
Phone (815) 568-4550

1186 W Maple Ave
Mundelein, IL 60060
Phone (847) 970-7099

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

Organizations & group practices 3

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1437255718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200",
            "fax_number": "630-928-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DEERFIELD PKWY",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600897500",
            "telephone_number": "847-215-0022",
            "fax_number": "847-465-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBISZEWSKI",
        "first_name": "GUSTAW",
        "middle_name": "JANUSZ",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014473",
            "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 Aug 30, 2017; 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.