Provider Demographics
NPI:1861889479
Name:KRYGLOWSKI, ALEXA (ATC)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:KRYGLOWSKI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7852 E PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3672
Mailing Address - Country:US
Mailing Address - Phone:321-890-4249
Mailing Address - Fax:
Practice Address - Street 1:7852 E PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3672
Practice Address - Country:US
Practice Address - Phone:847-491-8862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0039792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer