Provider Demographics
NPI:1396288346
Name:SZKWARLA, JOANNA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:
Last Name:SZKWARLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:MORAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:269 GOODRIDGE TER
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-3536
Mailing Address - Country:US
Mailing Address - Phone:630-290-6939
Mailing Address - Fax:
Practice Address - Street 1:3943 W 31ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-4936
Practice Address - Country:US
Practice Address - Phone:773-523-8773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2017-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085006024363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical