Provider Demographics
NPI:1306076906
Name:BIELAWIEC, ALEKSANDRA
Entity type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:BIELAWIEC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEKSANDRA
Other - Middle Name:
Other - Last Name:SMACZNIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22285 N PEPPER RD STE 302
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2541
Mailing Address - Country:US
Mailing Address - Phone:847-726-0774
Mailing Address - Fax:847-277-1549
Practice Address - Street 1:304 FOX GLEN CT
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1818
Practice Address - Country:US
Practice Address - Phone:847-726-0774
Practice Address - Fax:847-239-7919
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily