Individual
CONNIE MYJAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4421 S NANCY DR, CRYSTAL LAKE, IL 60014-6464
(815) 444-9746
Mailing address
4421 S NANCY DR, CRYSTAL LAKE, IL 60014-6464
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
IL
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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