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Individual

DEBRA LYNN PYSZKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
920 WEST ST, SUITE 211, PERU, IL 61354-2763
(815) 223-2143
Mailing address
1305 6TH ST, PERU, IL 61354-2759
(815) 780-4644

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085001304
BCBS-IL
IL
01
7071673
AETNA
IL
Enumeration date
10/23/2006
Last updated
08/22/2011
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