MEDICARE: MATTHEW A LESNIAK 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	05013718A	IN
2	225100000X	Physical Therapist	070017613	IL

General Provider Information

NPI Number	:	1659601672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW A LESNIAK PT

Provider Business Mailing Address
First Line	:	1377 MOTOR PKWY
Second Line	:	STE 307
City	:	ISLANDIA
State	:	NY
Zip	:	11749-5258
Country	:	US
Telephone Number	:	312-640-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	3454 S HALSTED ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-6743
Country	:	US
Telephone Number	:	773-254-5250
Fax Number	:

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

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	05/04/2023

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Directions to “ MATTHEW A LESNIAK PT” Practice Location

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