Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038009846 | IL |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 038-009846 | IL |
NPI | 1235165457 |
---|---|
Provider Name | Dr. Ronald James Losiewicz |
First Address | Willowbrook, IL 60527 |
Second Address | Lyons, IL 60534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 24/04/2008 |