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General NPI Number Information
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NPI Number | 1629595749
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Entity Type | Individual
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Provider Name | KATARZYNA TERESA BUKSA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | 906 WALTON ST.
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City | MELROSE PARK
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State | IL
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Zip | 60160
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Country | US
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Telephone | 708-450-2460
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Fax |
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Provider Business Mailing Address
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Address Line | 5014 N. CICERO AVENUE
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City | CHICAGO
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State | IL
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Zip | 60630
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Country | US
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Telephone | 773-803-1278
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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