Provider Demographics
NPI:1437316536
Name:PASEK, LAUREN IRENE (DT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:IRENE
Last Name:PASEK
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 W AZALEA AVE
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449-8765
Mailing Address - Country:US
Mailing Address - Phone:708-534-6472
Mailing Address - Fax:
Practice Address - Street 1:4531 W AZALEA AVE
Practice Address - Street 2:
Practice Address - City:MONEE
Practice Address - State:IL
Practice Address - Zip Code:60449-8765
Practice Address - Country:US
Practice Address - Phone:708-534-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist