Individual
MRS. ADRIANA WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1366 W FULLERTON AVE, CHICAGO, IL 60614-2129
(773) 248-9300
Mailing address
1835 W OAKDALE AVE UNIT I, CHICAGO, IL 60657-4055
(708) 691-2670
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008450
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160.008450
LICENSED PHYSICAL THERAPIST ASSISTANT
IL
Enumeration date
11/21/2018
Last updated
11/21/2018
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