Provider Demographics
NPI:1639193972
Name:PAJERSKI, MARINA (PT)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:PAJERSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:
Other - Last Name:VAYMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1845 OAK ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3022
Mailing Address - Country:US
Mailing Address - Phone:847-446-5420
Mailing Address - Fax:847-446-5426
Practice Address - Street 1:1845 OAK ST STE 1
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3022
Practice Address - Country:US
Practice Address - Phone:847-446-5420
Practice Address - Fax:847-446-5426
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-012655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632135OtherBCBS#
ILK16050OtherMEDICARE PIN#
ILK16050OtherMEDICARE PIN#
IL210033Medicare ID - Type UnspecifiedMEDICARE GROUP #