Provider Demographics
NPI:1417271909
Name:LIJEWSKI, ANDREW ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ALAN
Last Name:LIJEWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W SILVER SPRING DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4218
Mailing Address - Country:US
Mailing Address - Phone:414-395-1279
Mailing Address - Fax:414-488-0046
Practice Address - Street 1:2500 W SILVER SPRING DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-4218
Practice Address - Country:US
Practice Address - Phone:414-395-1279
Practice Address - Fax:414-488-0046
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4601-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor