Healthcare Provider Details

I. General information

NPI: 1962294157
Provider Name (Legal Business Name): PATRYK RYCZEK PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 S RAND RD
LAKE ZURICH IL
60047-2467
US

IV. Provider business mailing address

PO BOX 416501
BOSTON MA
02241-7594
US

V. Phone/Fax

Practice location:
  • Phone: 847-550-4580
  • Fax:
Mailing address:
  • Phone: 914-294-4050
  • Fax: 631-760-8306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070029234
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: