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General NPI Number Information
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NPI Number | 1093604696
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Entity Type | Individual
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Provider Name | GWYN K GOLEMBIEWSKI
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 920 E OAK ST
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-6173
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Country | US
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Telephone | 779-800-5024
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Fax |
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Provider Business Mailing Address
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Address Line | 1480 STARFISH LN
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City | SYCAMORE
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State | IL
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Zip | 60178-8621
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.117026
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License Number State | IL
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