Provider Demographics
NPI:1730324153
Name:ZEPELAK, TIMOTHY PATRICK (PT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:ZEPELAK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6960 NORTH SHERIDAN ROAD
Mailing Address - Street 2:1A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626
Mailing Address - Country:US
Mailing Address - Phone:773-793-3483
Mailing Address - Fax:773-856-6440
Practice Address - Street 1:6960 N SHERIDAN RD
Practice Address - Street 2:1A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-3888
Practice Address - Country:US
Practice Address - Phone:773-793-3483
Practice Address - Fax:773-856-6440
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700112162251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic