Provider Demographics
NPI:1871618025
Name:CHMIELEWSKI, MARIA (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 W DIVERSEY PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1207
Mailing Address - Country:US
Mailing Address - Phone:773-549-2520
Mailing Address - Fax:773-549-2743
Practice Address - Street 1:2837 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3624
Practice Address - Country:US
Practice Address - Phone:773-528-7502
Practice Address - Fax:773-528-7702
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009592225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist