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NPI Code Detail

MEDICARE: MR. DREW ALAN FITZANKO PT

MEDICARE:  MR. DREW ALAN FITZANKO  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
1225100000XPhysical Therapist070010923IL

General Provider Information

NPI Number : 1891754776
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DREW ALAN FITZANKO PT
Provider Business Mailing Address
First Line : 209 S UNION ST
Second Line :
City : BYRON
State : IL
Zip : 61010-1458
Country : US
Telephone Number : 815-234-5553
Fax Number : 815-234-5557
Provider Business Practice Location Address
First Line : 209 N. UNION ST.
Second Line :
City : BYRON
State : IL
Zip : 61010-0600
Country : US
Telephone Number : 815-234-5553
Fax Number : 815-234-5557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2006
Last Update Date : 09/05/2012

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Directions to “ MR. DREW ALAN FITZANKO PT” Practice Location

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