Individual provider Active NPI

Mateusz J Zapotoczny, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1861098774
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-025655 Issued in IL
Practice address
1103 S State St
Chicago, IL 60605-2733
Phone
(312) 877-5101
Fax
(312) 877-5906
NPI assigned
Dec 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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 070-025655 IL Primary

Addresses

Primary practice location

1103 S State St
Chicago, IL 60605-2733

Mailing address

1103 S State St
Chicago, IL 60605-2733
Phone (312) 877-5101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221000137 IL Practitioner - Physical Therapist in Private Practice 1254743024 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Real PT LLCGroup PAC ID 4789015983, 6 clinicians

Practice addresses (Care Compare)

1659 W Hubbard St
Chicago, IL 60622-6352
Phone (312) 489-8579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-025655ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipt Management Services, Inc. Physical Therapist CurrentSince Jul 27, 2022 Accepting new patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 7, 2020 Accepting new patients
Sports and Ortho P.C CurrentSince Oct 18, 2021 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 7, 2020 Accepting new patients
Real PT LLC CurrentSince Apr 16, 2025 Accepting new patients

Locations

1103 S State St
Ste 300
Chicago, IL 60605
Phone (312) 877-5101

24 S Morgan St
Ste 100
Chicago, IL 60607
Phone (312) 421-7274

1659 W Hubbard St
Chicago, IL 60622
Phone (312) 489-8579

1509 S Michigan Ave
Chicago, IL 60605
Phone (312) 431-0434

412 W 31st St
Chicago, IL 60616
Phone (312) 225-3119

1103 S State St
Chicago, IL 60605
Phone (312) 877-5101

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

Organizations & group practices 6

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": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1861098774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052733",
            "telephone_number": "312-877-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052733",
            "telephone_number": "312-877-5101",
            "fax_number": "312-877-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAPOTOCZNY",
        "first_name": "MATEUSZ",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-07",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-025655",
            "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 28, 2022; 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.

Verify at the official NPI Registry.