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General NPI Number Information
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NPI Number | 1235296138
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Entity Type | Individual
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Provider Name | ANTHONY J BARTKOWIAK PAC DC
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 1110 W SCHICK RD
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City | BARTLETT
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State | IL
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Zip | 60103-3007
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Country | US
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Telephone | 630-372-1100
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Fax | 630-372-6230
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Provider Business Mailing Address
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Address Line | 1110 W SCHICK RD
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City | BARTLETT
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State | IL
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Zip | 60103-3007
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Country | US
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Telephone | 630-372-1100
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Fax | 630-372-6230
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038007742
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085001660
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License Number State | IL
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