Provider Demographics
NPI:1609818129
Name:GAWRON, PEGGY (MA, CCC/SLP-L)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:
Last Name:GAWRON
Suffix:
Gender:F
Credentials:MA, CCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6446 BAZZ DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-8677
Mailing Address - Country:US
Mailing Address - Phone:815-577-9895
Mailing Address - Fax:
Practice Address - Street 1:857 CENTER CT
Practice Address - Street 2:STE D
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60431-8519
Practice Address - Country:US
Practice Address - Phone:815-730-1818
Practice Address - Fax:815-730-0808
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
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