Provider Demographics
NPI:1588342695
Name:BUNDYRA, KATARZYNA BARBARA
Entity type:Individual
Prefix:MRS
First Name:KATARZYNA
Middle Name:BARBARA
Last Name:BUNDYRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10571 PALOS PL UNIT A
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-3277
Mailing Address - Country:US
Mailing Address - Phone:708-495-8882
Mailing Address - Fax:
Practice Address - Street 1:9000 W COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1444
Practice Address - Country:US
Practice Address - Phone:708-608-4323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070027281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist