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General NPI Number Information
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NPI Number | 1497250302
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Entity Type | Individual
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Provider Name | JAN CHRISTOPHER SITKO ATC, LPN
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Gender | Male
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Dates
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Enumeration Date | 03/25/2018
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 6000 W TOUHY AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60646-1248
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Country | US
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Telephone | 773-774-4291
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Fax | 773-774-4527
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Provider Business Mailing Address
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Address Line | 6000 W TOUHY AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60646-1248
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Country | US
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Telephone |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 043.116227
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License Number State | IL
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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 | 096.004640
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License Number State | IL
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