Provider Demographics
NPI:1831860824
Name:BARTNICKA, MARGARET (PTA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BARTNICKA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 TRACE DR APT 110
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4098
Mailing Address - Country:US
Mailing Address - Phone:847-274-4919
Mailing Address - Fax:
Practice Address - Street 1:555 MCHENRY RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-3856
Practice Address - Country:US
Practice Address - Phone:847-537-2900
Practice Address - Fax:847-808-6240
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160003172225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant