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General NPI Number Information
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NPI Number | 1851509277
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Entity Type | Individual
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Provider Name | PAUL C POLLACHEK RN,BS
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6846 PRAIRIE RUN AVE
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City | PORTAGE
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State | IN
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Zip | 46368-2665
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Country | US
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Telephone | 219-628-1292
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Fax | 219-764-8256
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Provider Business Mailing Address
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Address Line | 6846 PRAIRIE RUN AVE
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City | PORTAGE
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State | IN
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Zip | 46368-2665
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Country | US
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Telephone | 219-628-1292
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Fax | 219-764-8256
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28112325A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704232837
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number |
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License Number State | IL
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