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Individual

DEREK WESOLOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
1975 LIN LOR LN, ELGIN, IL 60123-4902
(847) 468-6098
(847) 468-6095
Mailing address
2525 KANEVILLE RD, GENEVA, IL 60134-2578
(630) 584-1411
(630) 513-2630

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
753210
MEDICARE GROUP
01
CF2064
RAILROAD GROUP
01
K39995
MEDICARE
IL
Enumeration date
06/27/2007
Last updated
02/26/2008
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