Provider Demographics
NPI:1265593974
Name:MARK A SZYMANSKI, DCPC
Entity type:Organization
Organization Name:MARK A SZYMANSKI, DCPC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:SZYMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-625-2424
Mailing Address - Street 1:7311 W FOREST PRESERVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-3505
Mailing Address - Country:US
Mailing Address - Phone:773-625-2424
Mailing Address - Fax:773-625-2448
Practice Address - Street 1:7311 W FOREST PRESERVE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-3505
Practice Address - Country:US
Practice Address - Phone:773-625-2424
Practice Address - Fax:773-625-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK17678Medicare ID - Type UnspecifiedJULIE A TAPIO
ILV05193Medicare UPIN
ILT38411Medicare UPIN
IL395050Medicare ID - Type UnspecifiedMARK A SZYMANSKI