Individual
KONRAD MLECZKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 JAMESTOWN LN, LINCOLNSHIRE, IL 60069-2119
(224) 543-7100
Mailing address
7869 W CAHILL TER APT 3, CHICAGO, IL 60634-3793
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004563
IL
Other
Enumeration date
12/22/2019
Last updated
12/22/2019
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