Healthcare Provider Details

I. General information

NPI: 1831860824
Provider Name (Legal Business Name): MARGARET BARTNICKA PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 09/21/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 MCHENRY RD
WHEELING IL
60090-3856
US

IV. Provider business mailing address

890 TRACE DR APT 110
BUFFALO GROVE IL
60089-4098
US

V. Phone/Fax

Practice location:
  • Phone: 847-537-2900
  • Fax: 847-808-6240
Mailing address:
  • Phone: 847-274-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160003172
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: