Active NPI
Jaroslaw S Matejewski, PT
- Physical Therapist
- Bourbonnais, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070006737
- Practice address
- 215 N Convent St
Suite 6
Bourbonnais, IL 60914-5600 - Phone
- (815) 928-8357
- Fax
- (815) 929-0492
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070006737 | IL | Primary |
Addresses
Primary practice location
215 N Convent St
Suite 6
Bourbonnais, IL 60914-5600
Mailing address
625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
38 S Main St
Apt a
Sugar Grove, IL 60554-5031
Phone (630) 466-5866
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070006737 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC | Current | Accepting new patients | |
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path | Physical Therapist | Current | Accepting new patients |
Locations
557 Main St NW
Bourbonnais, IL 60914
Phone (815) 839-2090
215 N Convent St
Ste 6
Bourbonnais, IL 60914
Phone (815) 928-8357
204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225
280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219
625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250
722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088
38 S Main St
Apt A
Sugar Grove, IL 60554
Phone (630) 466-5866
1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749
Organizations & group practices 4
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.
-
- Physical Therapist
- Clinton, IL
- NPI 1376917187
-
- Physical Therapist
- Oak Brook, IL
- NPI 1821085028
-
- Physical Medicine & Rehabilitation Physician
- New York, NY
- NPI 1215637699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493337600000",
"number": "1639398191",
"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": "630-575-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N CONVENT ST",
"address_2": "SUITE 6",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609145600",
"telephone_number": "815-928-8357",
"fax_number": "815-929-0492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATEJEWSKI",
"first_name": "JAROSLAW",
"middle_name": "S",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2017-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070006737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bourbonnais, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.