Basic Information
Provider Information
NPI: 1528499522
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GLOGOWSKI
FirstName: KLAUDIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 205 W WACKER DR
Address2: SUITE 1020
City: CHICAGO
State: IL
PostalCode: 606061216
CountryCode: US
TelephoneNumber: 3126400329
FaxNumber:  
Practice Location
Address1: 8337 W LAWRENCE AVE
Address2:  
City: NORRIDGE
State: IL
PostalCode: 607063129
CountryCode: US
TelephoneNumber: 7085839500
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/02/2013
LastUpdateDate: 04/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X070020438ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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