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NPI Code Detail

MEDICARE: IRENEUSZ PAWLOWSKI MD

MEDICARE: IRENEUSZ PAWLOWSKI MD
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
1207R00000XInternal Medicine PhysicianIL

General Provider Information

NPI Number : 1588774616
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENEUSZ PAWLOWSKI MD
Provider Business Mailing Address
First Line : 3048 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-6624
Country : US
Telephone Number : 773-227-2821
Fax Number : 773-227-1904
Provider Business Practice Location Address
First Line : 3048 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-6624
Country : US
Telephone Number : 773-227-2821
Fax Number : 773-227-1904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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