MEDICARE: PAWEL DROZD PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05009859A	IN
2	225100000X	Physical Therapist	031369	NY

General Provider Information

NPI Number	:	1083946925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAWEL DROZD PT

Provider Business Mailing Address
First Line	:	10511 S ROBERTS RD APT 2D
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-3914
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10511 S ROBERTS RD APT 2D
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-3914
Country	:	US
Telephone Number	:	630-670-3130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2010
Last Update Date	:	02/03/2010

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Directions to “ PAWEL DROZD PT” Practice Location

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