Nicholas Kaczkowski, PT, DPT, MS
NPI 1083219596ActiveIndividual· Physical Therapist· Fox Lake, IL
Physical Therapist (PT, DPT, MS) in Fox Lake, Illinois, licensed in IL, with an NPI issued in December 2020. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1083219596 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT, MS |
| Sole proprietor | No |
| NPI issued | Dec 2, 2020 |
| Last updated in NPPES | Dec 2, 2020 |
| Certified by provider | Dec 2, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 070025353 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (WI) |
|---|
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