Provider Demographics
NPI:1629562459
Name:LEWANDOWSKI, ANDRZEJ (CCC-SLP, MHS)
Entity Type:Individual
Prefix:MR
First Name:ANDRZEJ
Middle Name:
Last Name:LEWANDOWSKI
Suffix:
Gender:M
Credentials:CCC-SLP, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 LAWRENCE AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:SCHILLER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60176-1216
Mailing Address - Country:US
Mailing Address - Phone:847-999-3990
Mailing Address - Fax:
Practice Address - Street 1:9950 LAWRENCE AVE STE 309
Practice Address - Street 2:
Practice Address - City:SCHILLER PARK
Practice Address - State:IL
Practice Address - Zip Code:60176-1216
Practice Address - Country:US
Practice Address - Phone:847-999-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.014096235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146.014096OtherIDFPR
IL146.014096OtherIDFPR