Provider Demographics
NPI:1013011493
Name:CZARNIEWSKI, ANDREW JERRY (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JERRY
Last Name:CZARNIEWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 95 STREET
Mailing Address - Street 2:SUITE #115
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564
Mailing Address - Country:US
Mailing Address - Phone:630-718-0848
Mailing Address - Fax:630-718-9868
Practice Address - Street 1:1935 95 STREET
Practice Address - Street 2:SUITE #115
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-718-0848
Practice Address - Fax:630-718-9868
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0227561OtherBCBS
IL0227561OtherBCBS
U85054Medicare UPIN