Healthcare Provider Details

I. General information

NPI: 1033159371
Provider Name (Legal Business Name): BARBARA KWIATKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA KWIATKOWSKI

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SALT CREEK LN STE 101
HINSDALE IL
60521-2990
US

IV. Provider business mailing address

11 SALT CREEK LN STE 101
HINSDALE IL
60521-2990
US

V. Phone/Fax

Practice location:
  • Phone: 630-789-3110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number147000411
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: