Provider Demographics
NPI:1528508629
Name:SZYSKA, SAMANTHA (DC)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:SZYSKA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 W HIGGINS AVE
Mailing Address - Street 2:STE 2A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-1949
Mailing Address - Country:US
Mailing Address - Phone:773-414-0435
Mailing Address - Fax:312-312-9620
Practice Address - Street 1:7001 W HIGGINS AVE
Practice Address - Street 2:STE 2A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-1949
Practice Address - Country:US
Practice Address - Phone:773-413-0435
Practice Address - Fax:312-312-9620
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor