Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 056.010051 | IL |
N | 225XP0200X | Occupational Therapist - Pediatrics | 056.010051 | IL |
NPI | 1467793109 |
---|---|
Provider Name | Mrs. Stephanie Biziarek |
First Address | Willow Springs, IL 60480-1638 |
Second Address | Aurora, IL 60504-8409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2013 |
Last Update Date | 15/05/2015 |