Provider Demographics
NPI:1184902744
Name:SZENDERSKI, DUSTIN (PT)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:SZENDERSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 CENTRAL AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5637
Mailing Address - Country:US
Mailing Address - Phone:847-681-8720
Mailing Address - Fax:847-681-9020
Practice Address - Street 1:799 CENTRAL AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5637
Practice Address - Country:US
Practice Address - Phone:847-681-8720
Practice Address - Fax:847-681-9020
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-018635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist