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General NPI Number Information
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NPI Number | 1417353319
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Entity Type | Individual
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Provider Name | PAULA M. DOBROWOLSKA CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 2202 HARLEM RD SUITE 200
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City | LOVES PARK
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State | IL
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Zip | 61111-2754
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Country | US
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Telephone | 815-877-4848
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Fax | 815-654-5342
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Provider Business Mailing Address
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Address Line | 2202 HARLEM RD SUITE 200
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City | LOVES PARK
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State | IL
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Zip | 61111-2754
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Country | US
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Telephone | 815-877-4848
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Fax | 815-654-5342
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28239684A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209-012071
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License Number State | IL
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