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General NPI Number Information
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NPI Number | 1447659305
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Entity Type | Individual
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Provider Name | CHRISTOPHER PATRICK TOMCZYK MS, ATC
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Gender | Male
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Dates
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Enumeration Date | 08/16/2014
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 3240 W WARNER AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60618-2312
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Country | US
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Telephone | 610-750-1293
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Fax |
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Provider Business Mailing Address
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Address Line | 3240 W WARNER AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60618-2312
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Country | US
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Telephone | 610-750-1293
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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 | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | AT002965
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2601002171
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License Number State | MI
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