Provider Demographics
NPI:1053969774
Name:MAREK, ALEXANDRA S (PTA)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:S
Last Name:MAREK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:S
Other - Last Name:KOWALEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:929 W HIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195-3203
Mailing Address - Country:US
Mailing Address - Phone:847-285-4200
Mailing Address - Fax:847-885-0130
Practice Address - Street 1:929 W HIGGINS RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-3203
Practice Address - Country:US
Practice Address - Phone:847-285-4200
Practice Address - Fax:847-885-0130
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160008700225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant