MEDICARE: KAMILA HELENA KAWA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1023737590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMILA HELENA KAWA

Provider Business Mailing Address
First Line	:	806 E OLD WILLOW RD APT 216
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-2106
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	806 E OLD WILLOW RD APT 216
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-2106
Country	:	US
Telephone Number	:	773-956-2479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2022
Last Update Date	:	08/26/2022

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Directions to “ KAMILA HELENA KAWA ” Practice Location

Language	Start Address	Practice Location

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