Most Relevant Information
Provider Data
| NPI Number: | 1003475146 |
| Provider Name: | NICOLE MARIE LESAK PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 070024748 |
Most Important Dates
| Enumeration Date: | 06/12/2019 |
| Last Updated: | 09/11/2019 |
Provider Practice Location
1801 S HIGHLAND AVE STE L1
LOMBARD
IL
601484932
Practice Location Phone/Fax
| Phone: | 6304699200 |
| Fax: |
Provider Mailing Location
1860 PAYSPHERE CIR
CHICAGO
IL
606748287
Provider Mailing Phone/Fax
| Phone: | 6304692000 |
| Fax: |