Adam Kotowski, LSW, MSW, MBA

Individual provider Active NPI Social Worker · Mazon, IL

NPI 1962360610 · NPPES record last updated Jan 12, 2026

Key facts

NPI
1962360610
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
150.116309 (IL)
Practice address
606 Depot St
Mazon, IL 60444-3703
Phone
(815) 315-8380
Fax
(815) 315-8381
NPI assigned
Jan 12, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
150.116309ILMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.116309 IL Yes

Addresses

Primary practice location

606 Depot St
Mazon, IL 60444-3703

Mailing address

606 Depot St
Mazon, IL 60444-3703
Phone (815) 315-8380

Other providers in Mazon, IL

All providers in Mazon, IL · Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.