Provider Demographics
NPI:1215979067
Name:MAJESKI, KATHLEEN A (PT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:MAJESKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:2403 HARNISH DR
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-6803
Practice Address - Country:US
Practice Address - Phone:847-854-6482
Practice Address - Fax:847-854-6483
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070006350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL568150OtherMEDICARE GROUP NUMBER
IL1623066OtherBCBS PROVIDER NUMBER
IL568080OtherMEDICARE GROUP NUMBER
IL1619980OtherBCBS IL GROUP NUMBER
IL567700OtherMEDICARE GROUP NUMBER
IL1619980OtherBCBS IL GROUP NUMBER
IL1623066OtherBCBS PROVIDER NUMBER
IL567700OtherMEDICARE GROUP NUMBER
IL200852Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
ILK51723Medicare PIN