Individual provider Active NPI

Kelly R Roszczybiuk, DPT

  • Physical Therapist
  • Deerfield, IL
National Provider Identifier
1700211695
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-020245 Issued in IL
Practice address
130 Waukegan Rd
Deerfield, IL 60015-5652
Phone
(872) 201-8527
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 070-020245 IL Primary

Addresses

Primary practice location

130 Waukegan Rd
Deerfield, IL 60015-5652

Mailing address

1517 Lake Ave
Wilmette, IL 60091-1637
Phone (815) 735-4337

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-020245ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

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

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

1002 Commons Dr
Geneva, IL 60134
Phone (630) 208-7831

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

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

967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237

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

Organizations & group practices 1

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": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1700211695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 LAKE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911637",
            "telephone_number": "815-735-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WAUKEGAN RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155652",
            "telephone_number": "872-201-8527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSZCZYBIUK",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-020245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.