Basic Information
Provider Information
NPI: 1316993710
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SLOWINSKA
FirstName: ILONA
MiddleName: M
NamePrefix: MS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5005 NEWPORT DR
Address2: SUITE 401
City: ROLLING MEADOWS
State: IL
PostalCode: 600083832
CountryCode: US
TelephoneNumber: 8477971050
FaxNumber: 8477971337
Practice Location
Address1: 105 N GREENLEAF ST
Address2:  
City: GURNEE
State: IL
PostalCode: 600313326
CountryCode: US
TelephoneNumber: 8472638880
FaxNumber: 8472638885
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 09/10/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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