Healthcare Provider Details

I. General information

NPI: 1427241884
Provider Name (Legal Business Name): PAULINA LOWKIS RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULINA PACZOCHA RD, LDN

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 W LAKE ST
ADDISON IL
60101-1870
US

IV. Provider business mailing address

3040 W SALT CREEK LN 3RD FLOOR
ARLINGTON HEIGHTS IL
60005-1069
US

V. Phone/Fax

Practice location:
  • Phone: 847-472-2145
  • Fax: 847-981-5765
Mailing address:
  • Phone: 847-385-7334
  • Fax: 847-483-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: