Matthew Hagenswiecicki, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036159328 Issued in IL

Practice address

1010 Lake St Ste 301
Oak Park, IL 60301-1133

Phone

(708) 524-8600

Fax

(708) 245-5721

NPI assigned

Jun 3, 2019

Last updated

Apr 23, 2024By the provider in NPPES

Sex

Male

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Street Family Physicians SC IncGroup PAC ID 8123081189, 8 clinicians

Dynamic Physical Therapy, Inc.Group PAC ID 4284607680, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Suburban Medical Center Hospital, Oak Park, IL, CCN 140049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HFAFDD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Street Family Physicians SC Inc

  • Family Medicine Physician
  • Oak Park, IL
  • NPI 1841363850
  Medicare reassignment Care Compare group NPD
• Rush Medical Group

  dba Rush Orthopaedics

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1467312850
  Medicare reassignment
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment
• Dynamic Physical Therapy, Inc.

  dba Body Gears - Lincoln Park

  • Rehabilitation Clinic/Center
  • Chicago, IL
  • NPI 1962974824
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Resilience Healthcare-West Suburban Medical Center, LLC

  dba West Suburban Medical Center

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1619442266
  Care Compare affiliation

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1730747924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 301",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011133",
            "telephone_number": "708-524-8600",
            "fax_number": "708-524-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 301",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011133",
            "telephone_number": "708-524-8600",
            "fax_number": "708-245-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGENSWIECICKI",
        "first_name": "MATTHEW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036159328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashon M Gurrola, APRN
• Stacey Gusak
• Sandra Cristina Hadley, OTR
• Alison Rew Hafner, LCSW
• John M Hagen, D.C.
• Terri Hager, MSW, LISW
• Jamie H Hahm, O.D.
• Chin-Lo Hahn, DDS, MS, PHD
• Julia Therese Haines, DPT
• Hair Butterflies Inc.

• Family Medicine Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.