Healthcare Provider Details

I. General information

NPI: 1871405316
Provider Name (Legal Business Name): GRACE SLIWINSKI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 GERRY DR
WOOD DALE IL
60191-1129
US

IV. Provider business mailing address

17W728 BUTTERFIELD RD APT 312
OAKBROOK TERRACE IL
60181-4239
US

V. Phone/Fax

Practice location:
  • Phone: 847-553-4009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: