Provider Demographics
NPI:1144049347
Name:GASIOROWSKI, ANDRZEJ
Entity type:Individual
Prefix:
First Name:ANDRZEJ
Middle Name:
Last Name:GASIOROWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 E 25TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1480
Mailing Address - Country:US
Mailing Address - Phone:815-535-1694
Mailing Address - Fax:
Practice Address - Street 1:409 W COMANCHE AVE
Practice Address - Street 2:
Practice Address - City:SHABBONA
Practice Address - State:IL
Practice Address - Zip Code:60550-9790
Practice Address - Country:US
Practice Address - Phone:815-824-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist