MEDICARE: KATARZYNA TARKOWSKA-SZUDY

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	183500000X	Pharmacist	2602260A	IN
2	183500000X	Pharmacist	051293158	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8435	OTHER	IN	8435

General Provider Information

NPI Number	:	1568074680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARZYNA TARKOWSKA-SZUDY

Provider Business Mailing Address
First Line	:	1301 119TH ST
Second Line	:
City	:	WHITING
State	:	IN
Zip	:	46394-1602
Country	:	US
Telephone Number	:	219-659-0299
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 119TH ST
Second Line	:
City	:	WHITING
State	:	IN
Zip	:	46394-1602
Country	:	US
Telephone Number	:	219-659-0299
Fax Number	:	219-659-7660

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

Provider Enumeration Date	:	08/19/2020
Last Update Date	:	08/19/2020

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Directions to “ KATARZYNA TARKOWSKA-SZUDY ” Practice Location

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