Individual provider Active NPI

Agata Kuczynska, M.A

  • Speech-Language Pathologist
  • Park Ridge, IL
National Provider Identifier
1992168967
Registry record updated Nov 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.003815 Issued in IL
Practice address
1580 N Northwest Hwy Ste 305a
Park Ridge, IL 60068-1469
Phone
(312) 401-2065
Fax
(312) 312-9598
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.003815 IL Primary

Addresses

Primary practice location

1580 N Northwest Hwy Ste 305a
Park Ridge, IL 60068-1469

Mailing address

7764 N Nora Ave
Niles, IL 60714-4740
Phone (312) 401-2065

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
242.003815ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lotus Speech Academy Speech-Language Pathologist CurrentSince Dec 22, 2020 Accepting new patients

Locations

1580 N Northwest Hwy
Ste 305A
Park Ridge, IL 60068
Phone (224) 636-1212

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762560000000",
    "number": "1992168967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7764 N NORA AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144740",
            "telephone_number": "312-401-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 N NORTHWEST HWY STE 305A",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681469",
            "telephone_number": "312-401-2065",
            "fax_number": "312-312-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCZYNSKA",
        "first_name": "AGATA",
        "credential": "M.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2025-11-08",
        "certification_date": "2025-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.003815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2025; 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.