Provider Demographics
NPI:1235165457
Name:LOSIEWICZ, RONALD JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JAMES
Last Name:LOSIEWICZ
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 1:6149 KNOLL WOOD ROAD
Mailing Address - Street 2:UNIT 202
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527
Mailing Address - Country:US
Mailing Address - Phone:708-442-3050
Mailing Address - Fax:708-442-3058
Practice Address - Street 1:3840 S HARLEM AVENUE
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:IL
Practice Address - Zip Code:60534
Practice Address - Country:US
Practice Address - Phone:708-442-3050
Practice Address - Fax:708-442-3058
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009846111NX0800X
IL038009846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic