NPI 1053585398

Joanna Tkacz, AGENT

Practitioner Contractor Chicago, IL

Practice location

Address: 5304 S Melvina Ave, Chicago, IL 60638-2618
Phone: (773) 581-1698

Registered specialties (2)

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence ACC/HEALTH--11/09/06 (IL)

Other Contractor providers in Illinois →

Contractor

Other Service Providers Taxonomy 171W00000X Licence ACC/HEALTH (IL)

Registry record

NPI: 1053585398
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Apr 2008
Record last updated: 17 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.