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General NPI Number Information
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NPI Number | 1003721283
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Entity Type | Individual
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Provider Name | EMILY PUSTELNIK DPT
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Gender | Female
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 406 S 4TH ST
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City | BASIN
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State | WY
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Zip | 82410-5011
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Country | US
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Telephone | 307-568-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 16333 OLCOTT AVE
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City | TINLEY PARK
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State | IL
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Zip | 60477-1518
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Country | US
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Telephone | 708-224-1316
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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