Individual
MRS. MARY SAMULAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3703 W LAKE AVE, SUITE200, GLENVIEW, IL 60026-5823
(847) 998-1188
Mailing address
3400 W STONEGATE BLVD, APT 219, ARLINGTON HEIGHTS, IL 60005-1045
(269) 964-3993
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.007492
IL
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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