Kylie Wielgopolan, OT, CHT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

056010241 Issued in IL

Practice address

4996 Illinois Route 159
Suite B
Maryville, IL 62062

Phone

(618) 288-4677

NPI assigned

May 1, 2024

Sex

Female

Sole proprietor

No

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

Enrolled in IL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Apex Physical Therapy, LLC

  • Specialist
  • Highland, IL
  • NPI 1033166061
  Medicare reassignment Care Compare group NPD
• Apex Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Centerton, AR
  • NPI 1710732607
  NPD

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1598512246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2491 INDUSTRIAL CT STE 100",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491365",
            "telephone_number": "815-488-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4996 ILLINOIS ROUTE 159",
            "address_2": "SUITE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-288-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIELGOPOLAN",
        "first_name": "KYLIE",
        "credential": "OT, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "IL",
            "license": "056010241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric L Wessel, PT
• Jennifer D Wesselman-Williams, NP
• Magen Seleste Westenberger, LCSW
• Kimberly Sue Wiegand, CFM
• Sarah E Wiegman, PA-C
• Richard Henry Wikiera, D.O.
• Alisha Wilken, DPT
• Matthew A Wilkinson, LCPC
• Whitney Williams
• Tina A Winter, FNP

• Hand Occupational Therapist in Maryville, IL
• Providers in Maryville, IL by specialty
• Hand Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.