Healthcare Provider Details

I. General information

NPI: 1992609440
Provider Name (Legal Business Name): KRPT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 WAUKEGAN RD
DEERFIELD IL
60015-5652
US

IV. Provider business mailing address

130 WAUKEGAN RD
DEERFIELD IL
60015-5652
US

V. Phone/Fax

Practice location:
  • Phone: 815-735-4337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KELLY ROSZCZYBIUK
Title or Position: SOLE OWNER
Credential: DPT
Phone: 815-735-4337