DR. JEFFREY DAVID KAZMIERCZAK PSY.D NPI 1902178015

NPI Information

  • NPI: 1902178015
  • Provider Name: DR. JEFFREY DAVID KAZMIERCZAK, PSY.D
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 19 HERITAGE PLZ
    SUITE 211
    BOURBONNAIS, IL
    ZIP 60914
  • Phone: (815) 933-8760

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NPI Details

DR. Jeffrey David Kazmierczak, PSY.D is a clinical neuropsychologist in Bourbonnais, IL. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. DR. Jeffrey David Kazmierczak, PSY.D NPI is 1902178015. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

19 HERITAGE PLZ
SUITE 211
BOURBONNAIS, IL
ZIP 60914-369
Phone: (815) 933-8760
Fax: (815) 933-9061

The NPI 1902178015 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 2/4/2012 and was last updated on 4/9/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical071008293ILLINOISNo
2103TA0700XPsychologistAdult Development & AgingNo
3103TC2200XPsychologistClinical Child & AdolescentNo
4103TC1900XPsychologistCounselingNo
5103TR0400XPsychologistRehabilitationNo
6103TF0200XPsychologistForensic071008293ILLINOISNo
7103G00000XClinical Neuropsychologist071008293ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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