Provider Demographics
NPI:1326209248
Name:BIBZAK, JOYCE E (DT)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:E
Last Name:BIBZAK
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19223 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-7509
Mailing Address - Country:US
Mailing Address - Phone:708-479-1463
Mailing Address - Fax:
Practice Address - Street 1:19223 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-7509
Practice Address - Country:US
Practice Address - Phone:708-479-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist