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NPI Code Detail

MEDICARE: DR. ALEKSANDRA MASIAK PT, DPT

MEDICARE: DR. ALEKSANDRA MASIAK PT, DPT
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
1225100000XPhysical Therapist070025133IL

General Provider Information

NPI Number : 1407455637
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEKSANDRA MASIAK PT, DPT
Provider Business Mailing Address
First Line : 3900 N DAMEN AVE APT 410
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3952
Country : US
Telephone Number : 630-806-9538
Fax Number :
Provider Business Practice Location Address
First Line : 852 MADISON ST
Second Line :
City : OAK PARK
State : IL
Zip : 60302-4441
Country : US
Telephone Number : 708-445-3965
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2020
Last Update Date : 10/19/2020

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