Provider Demographics
NPI:1356076608
Name:MARKUT, MALGORZATA STEFANIA (DPT)
Entity Type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:STEFANIA
Last Name:MARKUT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 GROSS POINT RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5080
Mailing Address - Country:US
Mailing Address - Phone:224-251-1160
Mailing Address - Fax:
Practice Address - Street 1:9650 GROSS POINT RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5080
Practice Address - Country:US
Practice Address - Phone:224-251-1160
Practice Address - Fax:224-251-1165
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist