IndividualActive
Adam Dziedzic, P.A.-C
NPI 1104935899 · Physician Assistant · Great Lakes, IL
Provider details
- NPI number
- 1104935899
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A.-C
- Sex
- Male
- Sole proprietor
- No
- License
- 085004025 (IL)
Mailing address
3410 Illinois St
Great Lakes, IL 60088-3120
Registry dates
- Enumerated
- 2006-08-29
- Last updated
- 2024-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.