Provider Demographics
NPI:1932311602
Name:SAMPLAWSKI, PHYLLIS LOUISE (MSW)
Entity Type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:LOUISE
Last Name:SAMPLAWSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ILLINOIS ST
Mailing Address - Street 2:#4
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-2704
Mailing Address - Country:US
Mailing Address - Phone:630-257-0148
Mailing Address - Fax:
Practice Address - Street 1:601 ILLINOIS ST
Practice Address - Street 2:#4
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-2704
Practice Address - Country:US
Practice Address - Phone:630-257-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical