Provider Demographics
NPI:1871929752
Name:BIELSKI, CHRISTA (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:BIELSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:1010 EXECUTIVE DR
Practice Address - Street 2:SUITE 250
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6135
Practice Address - Country:US
Practice Address - Phone:630-655-8785
Practice Address - Fax:630-655-2759
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020856225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist