Individual provider · Type 1 NPI
Evan Tkaczyk, PA-C
Medical Physician Assistant · Chicago, IL
NPI number
1790305704
Active
Practice location
2322 W Peterson Ave.
Chicago, IL 60659-3120
Mailing address
87 S 2nd Ave
Lombard, IL 60148
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
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About NPI 1790305704
Evan Tkaczyk, PA-C's National Provider Identifier is 1790305704, issued on Apr 20, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Chicago, IL. The record was last updated on Jan 31, 2021.