Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 181.000407 | IL |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 181.000407 | IL |
NPI | 1194483776 |
---|---|
Provider Name | Sabina K Wypych |
First Address | Mount Prospect, IL 60056-2806 |
Second Address | Mount Prospect, IL 60056-2806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2021 |
Last Update Date | 01/12/2021 |