Provider Demographics
NPI:1063028447
Name:EZPHYZIO PLLC
Entity type:Organization
Organization Name:EZPHYZIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTYLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-699-5460
Mailing Address - Street 1:615 S NOAH TER
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3533
Mailing Address - Country:US
Mailing Address - Phone:708-699-5460
Mailing Address - Fax:
Practice Address - Street 1:11269 WINDSOR PLACE CIRCLE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626
Practice Address - Country:US
Practice Address - Phone:813-444-0486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty