Provider Demographics
NPI:1386834216
Name:MICHALSKI, MICHELLE R
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:R
Last Name:MICHALSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W ALGONQUIN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4439
Mailing Address - Country:US
Mailing Address - Phone:847-956-0099
Mailing Address - Fax:847-956-0433
Practice Address - Street 1:515 W ALGONQUIN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4439
Practice Address - Country:US
Practice Address - Phone:847-956-0099
Practice Address - Fax:847-956-0433
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK39828Medicare PIN
ILK39827Medicare PIN