Individual
IGOR KOSCIUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSPT
Contact information
Practice address
1508 AURORA AVE, NAPERVILLE, IL 60540-6210
(630) 368-1771
Mailing address
28594 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070009754
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070009754
STATE LICENSE
IL
Enumeration date
08/21/2008
Last updated
02/19/2024
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