MEDICARE: PATRICK PIESYK

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1518841592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK PIESYK

Provider Business Mailing Address
First Line	:	PO BOX 458
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46308-0458
Country	:	US
Telephone Number	:	219-310-8366
Fax Number	:

Provider Business Practice Location Address
First Line	:	9321 WICKER AVE STE 105
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-2301
Country	:	US
Telephone Number	:	219-310-8366
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2025
Last Update Date	:	08/04/2025

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Directions to “ PATRICK PIESYK ” Practice Location

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