Individual
MR. DAVID CZARNECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
13114 WESTERN AVE, BLUE ISLAND, IL 60406-2439
(708) 824-0515
(708) 824-0517
Mailing address
13114 WESTERN AVE, BLUE ISLAND, IL 60406-2439
(708) 824-0515
(708) 824-0517
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160000470
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160000470
LICENSE
IL
Enumeration date
02/04/2007
Last updated
05/21/2012
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