MEDICARE: PAULINA POLEK M.A.,CCC-SLP

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	146012970	IL

General Provider Information

NPI Number	:	1336545482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULINA POLEK M.A.,CCC-SLP

Provider Business Mailing Address
First Line	:	400 S DRYDEN PL
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-2136
Country	:	US
Telephone Number	:	224-659-3241
Fax Number	:	847-749-0794

Provider Business Practice Location Address
First Line	:	400 S DRYDEN PL
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-2136
Country	:	US
Telephone Number	:	224-659-3241
Fax Number	:	847-749-0794

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

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	02/24/2016

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Directions to “ PAULINA POLEK M.A.,CCC-SLP” Practice Location

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