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NPI Code Detail

MEDICARE: BERNADETTE ZAJACZKOWSKI

MEDICARE: BERNADETTE ZAJACZKOWSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant160007333IL

General Provider Information

NPI Number : 1194486266
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERNADETTE ZAJACZKOWSKI
Provider Business Mailing Address
First Line : 14202 GARAVOGUE AVE
Second Line :
City : ORLAND PARK
State : IL
Zip : 60467-1152
Country : US
Telephone Number : 708-351-3683
Fax Number :
Provider Business Practice Location Address
First Line : 12220 WILL COOK RD
Second Line :
City : PALOS PARK
State : IL
Zip : 60464-7332
Country : US
Telephone Number : 630-257-2291
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2021
Last Update Date : 12/31/2021

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Directions to “ BERNADETTE ZAJACZKOWSKI ” Practice Location

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