Provider Demographics
NPI:1417924796
Name:WZOREK, ROBIN R (SLP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:R
Last Name:WZOREK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:R
Other - Last Name:WEIGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:4956 ROCKY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:BETHALTO
Mailing Address - State:IL
Mailing Address - Zip Code:62010-2540
Mailing Address - Country:US
Mailing Address - Phone:618-401-4201
Mailing Address - Fax:618-377-7011
Practice Address - Street 1:4956 ROCKY BRANCH RD
Practice Address - Street 2:
Practice Address - City:BETHALTO
Practice Address - State:IL
Practice Address - Zip Code:62010-2540
Practice Address - Country:US
Practice Address - Phone:618-401-4201
Practice Address - Fax:618-377-7011
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist