Provider Demographics
NPI:1457425290
Name:DABROWSKI, SLAWOMIR SZYMON (MD)
Entity Type:Individual
Prefix:
First Name:SLAWOMIR
Middle Name:SZYMON
Last Name:DABROWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 448
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:177-379-2330
Mailing Address - Fax:177-379-2334
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 448
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-792-3306
Practice Address - Fax:773-792-3346
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE85622Medicare UPIN