Provider Demographics
NPI:1730287939
Name:SZALOWSKI, E. ROGER (DN)
Entity Type:Individual
Prefix:DR
First Name:E.
Middle Name:ROGER
Last Name:SZALOWSKI
Suffix:
Gender:M
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 W CRYSTAL LAKE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-4204
Mailing Address - Country:US
Mailing Address - Phone:815-344-5522
Mailing Address - Fax:
Practice Address - Street 1:4106 W CRYSTAL LAKE RD
Practice Address - Street 2:SUITE A
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-4204
Practice Address - Country:US
Practice Address - Phone:815-344-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181-000158172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05625444OtherBLUE CROSS BLUE SHIELD
IL0007104279OtherAETNA