Provider Demographics
NPI:1104174721
Name:STRZELCZYK, THERESA A (APN, CNS)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:STRZELCZYK
Suffix:
Gender:F
Credentials:APN, CNS
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:A
Other - Last Name:HYNEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:251 E HURON ST
Mailing Address - Street 2:GALTER 8-138
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-1583
Mailing Address - Fax:312-926-6984
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:SUITE 19-100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-4965
Practice Address - Fax:312-695-5774
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000153364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health