Provider Demographics
NPI:1922363928
Name:OSTROWSKI, TAMMIE JO (PT)
Entity Type:Individual
Prefix:MS
First Name:TAMMIE
Middle Name:JO
Last Name:OSTROWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1465
Mailing Address - Country:US
Mailing Address - Phone:815-937-8220
Mailing Address - Fax:815-937-8222
Practice Address - Street 1:21 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1465
Practice Address - Country:US
Practice Address - Phone:815-937-8220
Practice Address - Fax:815-937-8222
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.012457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist