Provider Demographics
NPI:1356489694
Name:MAJERCIK PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MAJERCIK PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJERCIK
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:815-337-7410
Mailing Address - Street 1:201 N THROOP ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3224
Mailing Address - Country:US
Mailing Address - Phone:815-337-7410
Mailing Address - Fax:815-337-7412
Practice Address - Street 1:201 N THROOP ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3224
Practice Address - Country:US
Practice Address - Phone:815-337-7410
Practice Address - Fax:815-337-7412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206700Medicare ID - Type Unspecified