MEDICARE: RAQUEL BIELAWSKI

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	070007871	IL

General Provider Information

NPI Number	:	1790271484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAQUEL BIELAWSKI

Provider Business Mailing Address
First Line	:	1200 W ALGONQUIN RD BLDG M
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-7373
Country	:	US
Telephone Number	:	847-618-0121
Fax Number	:	847-618-0134

Provider Business Practice Location Address
First Line	:	1200 W ALGONQUIN RD BLDG M
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-7373
Country	:	US
Telephone Number	:	847-618-0121
Fax Number	:	847-618-0134

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

Provider Enumeration Date	:	07/05/2018
Last Update Date	:	07/05/2018

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Directions to “ RAQUEL BIELAWSKI ” Practice Location

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