MEDICARE: MR. ZYGMUNT BORKOWSKI PT

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		IL

General Provider Information

NPI Number	:	1558544205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ZYGMUNT BORKOWSKI PT

Provider Business Mailing Address
First Line	:	2819 WEST CORTEZ
Second Line	:	APT. 3E
City	:	CHICAGO
State	:	IL
Zip	:	60622
Country	:	US
Telephone Number	:	773-276-3721
Fax Number	:

Provider Business Practice Location Address
First Line	:	2819 WEST CORTEZ
Second Line	:	APT. 3E
City	:	CHICAGO
State	:	IL
Zip	:	60622
Country	:	US
Telephone Number	:	773-276-3721
Fax Number	:

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

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	12/17/2007

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