Individual provider Active NPI

Krystyna Pawelczyk

  • Physical Medicine & Rehabilitation Physician
  • Evanston, IL
National Provider Identifier
1558831743
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
160.006579 Issued in IL
Practice address
820 Foster St
Evanston, IL 60201-3212
Phone
(847) 492-7700
NPI assigned
Nov 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 160.006579 IL Primary

Addresses

Primary practice location

820 Foster St
Evanston, IL 60201-3212

Mailing address

832 E Old Willow Rd Apt 208
Prospect Heights, IL 60070-2124
Phone (847) 809-6629

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

State licenses

LicenseStateTypeSpecialty
160.006579ILMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1558831743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 E OLD WILLOW RD APT 208",
            "city": "PROSPECT HEIGHTS",
            "state": "IL",
            "postal_code": "600702124",
            "telephone_number": "847-809-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 FOSTER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013212",
            "telephone_number": "847-492-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWELCZYK",
        "first_name": "KRYSTYNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "160.006579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.