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NPI Code Detail

MEDICARE: HELEN GONDEK DPT

MEDICARE: HELEN GONDEK DPT
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
1208100000XPhysical Medicine & Rehabilitation Physician070018825IL

General Provider Information

NPI Number : 1215446182
Entity Type Code : Individual
Provider Name (Legal Business Name) : HELEN GONDEK DPT
Provider Business Mailing Address
First Line : PO BOX 362
Second Line :
City : SPRING GROVE
State : IL
Zip : 60081-0362
Country : US
Telephone Number : 815-675-0699
Fax Number : 815-675-0689
Provider Business Practice Location Address
First Line : 2900 N US HIGHWAY 12 STE J
Second Line :
City : SPRING GROVE
State : IL
Zip : 60081-8322
Country : US
Telephone Number : 815-675-0699
Fax Number : 815-675-0689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2017
Last Update Date : 09/23/2017

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Directions to “ HELEN GONDEK DPT” Practice Location

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