Provider Demographics
NPI:1346911682
Name:STAROWICZ, ANETA (MPT)
Entity Type:Individual
Prefix:
First Name:ANETA
Middle Name:
Last Name:STAROWICZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ANETA
Other - Middle Name:
Other - Last Name:STAROWICZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:52 JF KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3606
Mailing Address - Country:US
Mailing Address - Phone:630-414-9092
Mailing Address - Fax:
Practice Address - Street 1:1S376 SUMMIT AVE STE 5C
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3968
Practice Address - Country:US
Practice Address - Phone:773-800-1629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.026204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist