Provider Demographics
NPI:1497952246
Name:NOWAK, JOYCE (CRTT)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:NOWAK
Suffix:
Gender:F
Credentials:CRTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 E EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2908
Mailing Address - Country:US
Mailing Address - Phone:630-792-8905
Mailing Address - Fax:
Practice Address - Street 1:9003 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2502
Practice Address - Country:US
Practice Address - Phone:219-838-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN30004508A2278S1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedSNF/Subacute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN30004508AOtherRESPIRATORY CARE PRACTITI