Provider Demographics
NPI:1245274406
Name:OLSZEWSKI, MARY C (DPM)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:OLSZEWSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 E PALATINE RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-5119
Mailing Address - Country:US
Mailing Address - Phone:847-398-0900
Mailing Address - Fax:847-398-0973
Practice Address - Street 1:434 E PALATINE RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-5119
Practice Address - Country:US
Practice Address - Phone:847-398-0900
Practice Address - Fax:847-398-0973
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004266213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004266Medicaid
IL941283OtherUNITED HEALTHCARE
IL0001623060OtherBLUE CROSS BLUE SHIELD
IL480032539OtherRAILROAD MEDICARE
ILL73685Medicare PIN