Provider Demographics
NPI:1407983992
Name:KAWECKI, ROBIN W (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:W
Last Name:KAWECKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 OLCOTT AVE
Mailing Address - Street 2:NONESUCH HOUSE
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46323-2044
Mailing Address - Country:US
Mailing Address - Phone:219-902-6955
Mailing Address - Fax:219-228-8442
Practice Address - Street 1:2307 LAPORTE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-6996
Practice Address - Country:US
Practice Address - Phone:219-902-6955
Practice Address - Fax:219-228-8442
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001253A111N00000X
IL038007667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100424280CMedicaid
INM300038971OtherMEDICARE PTAN
IN405770Medicare PIN
INM300038971OtherMEDICARE PTAN