Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | IL |
NPI | 1245274406 |
---|---|
Provider Name | Mary C Olszewski |
First Address | Arlington Heights, IL 60004-3910 |
Second Address | Arlington Heights, IL 60004-3910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001623060 | BLUE CROSS BLUE SHIELD (01) | IL |
941283 | UNITED HEALTHCARE (01) | IL |
T90976 | (02) | IL |