MEDICARE: SHARON T RZYSKI SLP

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	235Z00000X	Speech-Language Pathologist	146006840	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01636839	OTHER	IL	BLUE SHIELD PROVIDER NUM

General Provider Information

NPI Number	:	1700908712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON T RZYSKI SLP

Provider Business Mailing Address
First Line	:	7023 N WOLCOTT AVE # 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2311
Country	:	US
Telephone Number	:	773-771-9555
Fax Number	:

Provider Business Practice Location Address
First Line	:	7023 N WOLCOTT AVE # 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2311
Country	:	US
Telephone Number	:	773-771-9555
Fax Number	:

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/09/2011

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Directions to “ SHARON T RZYSKI SLP” Practice Location

Language	Start Address	Practice Location

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