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Individual

PAUL PLACZKOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
4555 LINCOLN HWY, MATTESON, IL 60443-2318
(708) 283-0021
(708) 283-0831
Mailing address
4555 LINCOLN HWY, MATTESON, IL 60443-2318

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002845
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
096.002845
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
03/03/2015
Last updated
03/03/2015
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