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Individual

MRS. AMANDA KLEZEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1010 N GLENVIEW CT, PALATINE, IL 60067-0628
(847) 772-2312
Mailing address
1010 N GLENVIEW CT, PALATINE, IL 60067-0628
(847) 772-2312

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01628190
BC BS OF ILLINOIS
IL
01
AK99220496P
EARLY INTERVENTION
IL
Enumeration date
11/08/2006
Last updated
07/08/2007
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