KELLY STANCZAK (DPT) – Physical Therapist, NPI 1003049073

KELLY STANCZAK (DPT) is a healthcare provider. based in Oak brook, Illinois. specializing in Physical Therapist. They hold the professional credentials DPT. They hold a License No. 070-017373 (IL). The NPI Number for KELLY STANCZAK (DPT) is 1003049073

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
KELLY STANCZAK (DPT)
NPI
1003049073
Phone
(630) 575-6250
Address
625 ENTERPRISE DR.
Enumeration Date
25 August 2009
Last Update Date
28 July 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8476955088
Graduation Year
2009 (17 years ago)
PAC ID
3577717800
Group Practice PAC ID
4789602681
Professional Enrollment ID
I20130213000562
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

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Provider Addresses for KELLY STANCZAK (DPT)

  • 625, Enterprise Drive, Oak Brook, DuPage County, Illinois, 60523, United States

    OAK BROOK, IL 605238813

    Phone: (630) 575-6250

    Fax: (630) 575-7450

    Type: Mailing

  • Lake Forest, East Deerpath, Central Business District, Lake Forest, Lake County, Illinois, 60045, United States

    LAKE FOREST, IL 600451952

    Phone: (847) 482-1433

    Fax: (847) 482-1483

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-02-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130213000562IPhysical Therapist In Private PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60523)

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Provider's Procedures

KELLY STANCZAK (DPT) performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYIL97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes113972
PHYSICAL THERAPYIL97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes9230

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789602681View full group profile
NameSpecialtyState
-IL
-IL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeVA
-MI
-IL
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeIL
-MI
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

How do payers reference KELLY STANCZAK (DPT)?
For KELLY STANCZAK (DPT), use NPI 1003049073 as the unique 10-digit identifier.
Is KELLY STANCZAK (DPT) shown as active in public data?
Registry records indicate KELLY STANCZAK (DPT) maintains an active NPI.
How would a patient describe KELLY STANCZAK (DPT)'s focus?
For KELLY STANCZAK (DPT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with KELLY STANCZAK (DPT)?
Directory geography for KELLY STANCZAK (DPT) centers on Oak Brook, Illinois.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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