Provider Demographics
NPI:1841631132
Name:GRABOWSKI, AGNIESZKA (MA, LCSW)
Entity type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N ORLEANS ST STE 350
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3145
Mailing Address - Country:US
Mailing Address - Phone:312-809-0298
Mailing Address - Fax:
Practice Address - Street 1:820 N ORLEANS ST
Practice Address - Street 2:SUITE 206
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3132
Practice Address - Country:US
Practice Address - Phone:708-204-2486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490160461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL201543752OtherTAXPAYER ID