Healthcare Provider Details

I. General information

NPI: 1629510441
Provider Name (Legal Business Name): MALGORZATA SKOWRON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 REMINGTON RD SUITE V
SCHAUMBURG IL
60173-4833
US

IV. Provider business mailing address

1305 REMINGTON RD SUITE V
SCHAUMBURG IL
60173-4833
US

V. Phone/Fax

Practice location:
  • Phone: 888-234-7628
  • Fax:
Mailing address:
  • Phone: 888-234-7628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number180.009629
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: