Provider Demographics
NPI:1821737669
Name:DRAG, SYLWIA (LSW)
Entity Type:Individual
Prefix:
First Name:SYLWIA
Middle Name:
Last Name:DRAG
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GEORGE ST APT 517
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-3170
Mailing Address - Country:US
Mailing Address - Phone:773-230-5697
Mailing Address - Fax:
Practice Address - Street 1:109 FAIRFIELD WAY STE 205
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1500
Practice Address - Country:US
Practice Address - Phone:630-237-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.105469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health