Konrad Mleczko
Occupational Therapy Assistant in Lincolnshire, IL. Individual provider (NPI-1).
NPI number1871132829
StatusActive
Last updated in NPPESDec 22, 2019
Details
- NPI
- 1871132829
- Entity type
- Individual (NPI-1)
- Name
- Konrad Mleczko
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 22, 2019
- Certification date
- Dec 22, 2019
- Last updated
- Dec 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 057004563 | IL | Yes |
Practice location
150 Jamestown LnLincolnshire, IL 60069-2119
Phone 224-543-7100
Mailing address
7869 W Cahill Ter Apt 3Chicago, IL 60634-3793
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