Provider Demographics
NPI:1073250718
Name:BUDZIAKOWSKI, MICHAL
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:BUDZIAKOWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CRABTREE LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-5113
Mailing Address - Country:US
Mailing Address - Phone:847-224-9368
Mailing Address - Fax:
Practice Address - Street 1:8170 33RD AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-4516
Practice Address - Country:US
Practice Address - Phone:952-541-2902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-15
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program