Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Ethan James Ksiazek, PA-C

Individual provider Medical Physician Assistant · NPI 1073381166

Mr. Ethan James Ksiazek, PA-C is a Medical Physician Assistant in Chicago, Illinois. Licensed in Iowa. Registered with an NPI since 2023.

Licensed in
IA
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

225 E Chicago Ave
Chicago, IL 60611-2991
Phone: (312) 227-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 085010244 (IA)

Record details

NPI number1073381166
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 18, 2023
Last updated in NPPESApril 25, 2024
Certification dateJanuary 14, 2024

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