Individual provider Active NPI

Krystyna Kuczaty, PT

  • Physical Therapist
  • Bolingbrook, IL
National Provider Identifier
1619389343
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.020654 Issued in IL
Practice address
218 N Bolingbrook Dr
Bolingbrook, IL 60440-2386
Phone
(630) 972-1541
Fax
(630) 972-1571
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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 070.020654 IL Primary

Addresses

Primary practice location

218 N Bolingbrook Dr
Bolingbrook, IL 60440-2386

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140718001183 IL Practitioner - Physical Therapist in Private Practice 2668698192 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.020654ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist Current Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jun 1, 2017 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jun 1, 2017 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Jun 1, 2018 Accepting new patients
Athletic &Therapeutic Institute of Naperville, LLC Physical Therapist CurrentSince Jun 1, 2018 Accepting new patients

Locations

218 N Bolingbrook Dr
Bolingbrook, IL 60440
Phone (630) 972-1541

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

120 Burr Ridge Pkwy
Burr Ridge, IL 60527
Phone (630) 570-5025

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743

Organizations & group practices 5

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1619389343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402386",
            "telephone_number": "630-972-1541",
            "fax_number": "630-972-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCZATY",
        "first_name": "KRYSTYNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.