| Doctor Name: | MR. SLAWOMIR KOSTECKI |
| NPI Number: | 1003070434 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1550 Southridge Trl Algonquin, IL - 601026607 |
| Business Phone Number: | 8474289629 |
| Business Fax Number: | |
| Mailing Address: | 1550 Southridge Trl, ALGONQUIN |
| State: | IL |
| Postal Code: | 601026607 |
| Phone Number: | 8474289629 |
| Fax Number: | 8478443848 |
| NPI Enumeration Date: | 07/15/2008 |
| NPI Last Update Date: | 07/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471S1302X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Sonography |
| Taxonomy Definition: | |