Provider Demographics
NPI:1750547394
Name:SPADLOWSKI, RICHARD W (RN)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:W
Last Name:SPADLOWSKI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 CARSON CT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-9310
Mailing Address - Country:US
Mailing Address - Phone:630-933-8081
Mailing Address - Fax:
Practice Address - Street 1:2100 S. 5TH AVENUE
Practice Address - Street 2:EDWARD HINES JR. HOSPITAL
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-8387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041224586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse