Provider Demographics
NPI:1588656557
Name:SOWINSKI, ANDRZEJ A (MD)
Entity Type:Individual
Prefix:
First Name:ANDRZEJ
Middle Name:A
Last Name:SOWINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95509
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-0509
Mailing Address - Country:US
Mailing Address - Phone:847-923-0011
Mailing Address - Fax:847-923-0713
Practice Address - Street 1:1025 W WISE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-3746
Practice Address - Country:US
Practice Address - Phone:847-923-0011
Practice Address - Fax:847-923-0713
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-096853208D00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036096853Medicaid
ILH11996Medicare UPIN
ILK21781Medicare PIN