Provider Demographics
NPI:1518959816
Name:KOLASKI, PAUL GREGORY (DC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GREGORY
Last Name:KOLASKI
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 1:2010 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 42
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4134
Mailing Address - Country:US
Mailing Address - Phone:847-593-3330
Mailing Address - Fax:
Practice Address - Street 1:2010 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 42
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4134
Practice Address - Country:US
Practice Address - Phone:847-593-3330
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-00436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37797Medicare UPIN
ILK09211Medicare ID - Type Unspecified