Individual
ANNA NOEL KIELTYKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114-2300
(815) 971-7000
Mailing address
525 S 5TH ST, WEST DUNDEE, IL 60118-2842
(331) 442-0332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070028355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
DC
01
—
568946544
BCBS
—
01
—
5874
HEALTH PARTNERS
—
Enumeration date
06/10/2024
Last updated
06/10/2024
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