Provider Demographics
NPI:1437210200
Name:OLKOSKI, JEFFREY S (PT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:S
Last Name:OLKOSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 S CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:ROYALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62983
Mailing Address - Country:US
Mailing Address - Phone:618-984-2463
Mailing Address - Fax:618-984-2463
Practice Address - Street 1:308 S CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:ROYALTON
Practice Address - State:IL
Practice Address - Zip Code:62983
Practice Address - Country:US
Practice Address - Phone:618-984-2463
Practice Address - Fax:618-984-2463
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
03923662OtherBLUE CROSS BLUE SHIELD
693327OtherHEALTHLINK
693327OtherHEALTHLINK