Individual
ANGELA L KLISZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
360 STATION DR, SUITE 250, CRYSTAL LAKE, IL 60014-7978
(815) 356-1750
(815) 356-1755
Mailing address
21075 SWENSON DR, STE 600, WAUKESHA, WI 53186-2062
(312) 640-0329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070013810
IL
225100000X
Physical Therapist
Primary
13635
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619980
BCBS OF IL
IL
01
—
1623066
BCBS PROVIDER NUMBER
IL
01
—
367885100
US DEPT OF LABOR
IL
Enumeration date
07/13/2006
Last updated
06/07/2018
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