Provider Demographics
NPI:1508801457
Name:DRAGOVIC, MAGDALENA J (ATC)
Entity Type:Individual
Prefix:MS
First Name:MAGDALENA
Middle Name:J
Last Name:DRAGOVIC
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:MAGDALENA
Other - Middle Name:
Other - Last Name:MYSLIWIEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:2955 SHETLAND LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-4105
Mailing Address - Country:US
Mailing Address - Phone:630-890-6247
Mailing Address - Fax:
Practice Address - Street 1:27650 FERRY RD
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3845
Practice Address - Country:US
Practice Address - Phone:630-225-2663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960021352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer