Provider Demographics
NPI:1558898585
Name:PASOWICZ, ROBIN (MA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:PASOWICZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 N RUSSEL ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2024
Mailing Address - Country:US
Mailing Address - Phone:847-899-6336
Mailing Address - Fax:
Practice Address - Street 1:3105 N WILKE RD STE H
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1450
Practice Address - Country:US
Practice Address - Phone:847-255-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242003971235Z00000X
IL146013811235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist