Active NPI
Kelsie Lynn Mazur, DPT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1841988268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.027066
- Practice address
- 1044 W Kinzie St
Chicago, IL 60642-6537 - Phone
- (312) 265-0492
- NPI assigned
- Apr 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | 070.027066 | IL | |
| Physical Therapist | 225100000X | 070.027066 | IL | Primary |
Addresses
Primary practice location
1044 W Kinzie St
Chicago, IL 60642-6537
Mailing address
4526 W 83Rd St
Chicago, IL 60652-3073
Phone (773) 716-5852
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070.027066 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1841988268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4526 W 83RD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606523073",
"telephone_number": "773-716-5852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 W KINZIE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606426537",
"telephone_number": "312-265-0492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZUR",
"first_name": "KELSIE",
"middle_name": "LYNN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-25",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "IL",
"license": "070.027066",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.027066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.