Individual
ILYSE F ZULTOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2533 N SOUTHPORT AVE, CHICAGO, IL 60614-7166
(773) 472-2731
(773) 472-2761
Mailing address
2533 N SOUTHPORT AVE, CHICAGO, IL 60614-7166
(773) 472-2731
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
70015939
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP
IL
01
—
568150
MEDICARE GROUP NUMBER
IL
Enumeration date
08/27/2007
Last updated
02/21/2014
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