Healthcare Provider Details

I. General information

NPI: 1114067873
Provider Name (Legal Business Name): WIOLETA MALGORZATA SKOWYRA RT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7355 W LELAND AVE
HARWOOD HEIGHTS IL
60706-4701
US

IV. Provider business mailing address

7355 W LELAND AVE
HARWOOD HEIGHTS IL
60706-4701
US

V. Phone/Fax

Practice location:
  • Phone: 170-886-7601
  • Fax:
Mailing address:
  • Phone: 170-886-7601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: