Provider Demographics
NPI:1497250302
Name:SITKO, JAN CHRISTOPHER (ATC, LPN)
Entity Type:Individual
Prefix:
First Name:JAN CHRISTOPHER
Middle Name:
Last Name:SITKO
Suffix:
Gender:M
Credentials:ATC, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 KINGSDALE RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-4039
Mailing Address - Country:US
Mailing Address - Phone:847-421-0746
Mailing Address - Fax:
Practice Address - Street 1:6000 W TOUHY AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-1248
Practice Address - Country:US
Practice Address - Phone:773-774-4291
Practice Address - Fax:773-774-4527
Is Sole Proprietor?:No
Enumeration Date:2018-03-25
Last Update Date:2018-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043.116227164W00000X
IL096.0046402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No164W00000XNursing Service ProvidersLicensed Practical Nurse