Provider Demographics
NPI:1376426288
Name:KURDZIEL, WIOLETTA A (COTA)
Entity type:Individual
Prefix:MRS
First Name:WIOLETTA
Middle Name:A
Last Name:KURDZIEL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 N NEVA AVE UNIT 212
Mailing Address - Street 2:
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-7243
Mailing Address - Country:US
Mailing Address - Phone:773-742-5820
Mailing Address - Fax:
Practice Address - Street 1:4330 N NEVA AVE UNIT 212
Practice Address - Street 2:
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-7243
Practice Address - Country:US
Practice Address - Phone:773-742-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.005780224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant