Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 160.007238 | IL |
NPI | 1013478734 |
---|---|
Provider Name | Karolina E Styrczula |
First Address | Chicago, IL 60638-1713 |
Second Address | Chicago, IL 60638-1713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2019 |
Last Update Date | 26/03/2019 |