Dziedzic, Adam Robert

Dziedzic, Adam Robert is an individual health care provider with primary practice located at 3410 Illinois St , Great Lakes IL 60088-3120. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dziedzic, Adam Robert can be contacted via phone (224) 610-8553.

Contact Information

Primary practice address
3410 Illinois St Great Lakes IL 60088-3120
Phone: (224) 610-8553
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085004025 Illinois

Profile Details

NPI number 1104935899
LBN Legal business name Dziedzic, Adam Robert
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Mar 12th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104935899 NPPES
Illinois Other 085004025 STATE OF ILLINOIS

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