Individual provider Active NPI

Piotr Pawlowski, CSA

  • Surgical Technologist
  • Northlake, IL
National Provider Identifier
1679846786
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
238.000133 Issued in IL
Practice address
256 Armitage Ave
Northlake, IL 60164-1705
Phone
(847) 951-3724
NPI assigned
Feb 21, 2012
Last updated
Feb 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X 238.000133 IL Primary

Addresses

Primary practice location

256 Armitage Ave
Northlake, IL 60164-1705

Mailing address

256 Armitage Ave
Northlake, IL 60164-1705
Phone (847) 951-3724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
238.000133ILMDSurgical Technologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1679846786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 ARMITAGE AVE",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601641705",
            "telephone_number": "847-951-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 ARMITAGE AVE",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601641705",
            "telephone_number": "847-951-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLOWSKI",
        "first_name": "PIOTR",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": "238.000133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northlake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.