Provider Demographics
NPI:1851315022
Name:SZYMKOWIAK, STEVEN J (MA, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:SZYMKOWIAK
Suffix:
Gender:M
Credentials:MA, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17102 STERLING CT
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3819
Mailing Address - Country:US
Mailing Address - Phone:312-816-7949
Mailing Address - Fax:
Practice Address - Street 1:999 KEDZIE AVE
Practice Address - Street 2:ATHLETIC DEPARTMENT
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2248
Practice Address - Country:US
Practice Address - Phone:708-335-5688
Practice Address - Fax:708-799-8292
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2255A2300XOtherSPEC./ATHLETIC TRAINER