Provider Demographics
NPI:1245340637
Name:BANCSI, DAWN DENISESINICKI (MPT)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:DENISESINICKI
Last Name:BANCSI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:DENISE
Other - Last Name:SINICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:5271 N JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-9377
Mailing Address - Country:US
Mailing Address - Phone:708-567-3891
Mailing Address - Fax:
Practice Address - Street 1:6775 PROSPERI DR
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-4789
Practice Address - Country:US
Practice Address - Phone:708-429-1260
Practice Address - Fax:708-429-6622
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology