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General NPI Number Information
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NPI Number | 1689566549
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Entity Type | Individual
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Provider Name | DANIEL FITZPATRICK BEDNAREK
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Gender | Male
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 2100 PFINGSTEN RD
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City | GLENVIEW
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State | IL
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Zip | 60026-1301
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Country | US
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Telephone | 847-657-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 6037 N NASSAU AVE
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City | CHICAGO
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State | IL
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Zip | 60631-2616
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Country | US
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Telephone | 872-232-9350
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 085011399
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License Number State | IL
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