MEDICARE: MRS. KATARZYNA BARBARA BUNDYRA

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	070027281	IL

General Provider Information

NPI Number	:	1588342695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATARZYNA BARBARA BUNDYRA

Provider Business Mailing Address
First Line	:	10571 PALOS PL UNIT A
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-3277
Country	:	US
Telephone Number	:	708-495-8882
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 W COLLEGE PKWY
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-1444
Country	:	US
Telephone Number	:	708-608-4323
Fax Number	:

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

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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