Individual provider Active NPI

Dariusz Zelazko

  • Physical Therapy Assistant
  • Lincolnwood, IL
National Provider Identifier
1992179345
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160007395 Issued in IL
Practice address
6610 N Kilbourn Ave
Lincolnwood, IL 60712-3326
Phone
(847) 322-6360
NPI assigned
Nov 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160007395 IL Primary

Addresses

Primary practice location

6610 N Kilbourn Ave
Lincolnwood, IL 60712-3326

Mailing address

6610 N Kilbourn Ave
Lincolnwood, IL 60712-3326

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

State licenses

LicenseStateTypeSpecialty
160007395ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1992179345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6610 N KILBOURN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6610 N KILBOURN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123326",
            "telephone_number": "847-322-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELAZKO",
        "first_name": "DARIUSZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160007395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.