Provider Demographics
NPI:1922071679
Name:MAJCHROWSKI, JASON M (ATC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:M
Last Name:MAJCHROWSKI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PHEASANT CT
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1723
Mailing Address - Country:US
Mailing Address - Phone:630-852-5093
Mailing Address - Fax:
Practice Address - Street 1:420 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-3241
Practice Address - Country:US
Practice Address - Phone:815-834-9901
Practice Address - Fax:815-834-9904
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
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