Provider Demographics
NPI:1770894628
Name:NOWAK, ANDREW FRANCIS (PT,DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:FRANCIS
Last Name:NOWAK
Suffix:
Gender:M
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 HIGHLAND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2160
Mailing Address - Country:US
Mailing Address - Phone:630-275-2600
Mailing Address - Fax:630-275-2698
Practice Address - Street 1:3551 HIGHLAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2160
Practice Address - Country:US
Practice Address - Phone:630-275-2600
Practice Address - Fax:630-275-2698
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.007515225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist