Individual
MRS. REBECCA SUE MACZKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
27650 FERRY RD, WARRENVILLE, IL 60555-3845
(630) 225-2345
(630) 225-2399
Mailing address
27650 FERRY RD, WARRENVILLE, IL 60555-3845
(630) 225-2345
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-003248
IL
363AS0400X
Surgical Physician Assistant
085-003248
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01279235
RR MEDICARE
IL
Enumeration date
08/22/2008
Last updated
07/11/2022
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