Jacek Tomasz Tomczak
Occupational Therapist in Chicago, IL. Individual provider (NPI-1).
NPI number1669019014
StatusActive
Last updated in NPPESDec 4, 2019
Details
- NPI
- 1669019014
- Entity type
- Individual (NPI-1)
- Name
- Jacek Tomasz Tomczak
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 4, 2019
- Last updated
- Dec 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 056013264 | IL | Yes |
Practice location
3718 W Cornelia AveChicago, IL 60618-5002
Phone 773-791-1157
Mailing address
3718 W Cornelia AveChicago, IL 60618-5002
Phone 773-791-1157
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