Provider Demographics
NPI:1588983753
Name:SKOWRONSKI ADAMIAK, PAULA (DDS)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:SKOWRONSKI ADAMIAK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6217 N KIRKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5025
Mailing Address - Country:US
Mailing Address - Phone:312-296-1933
Mailing Address - Fax:
Practice Address - Street 1:542 W DUNDEE RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-3227
Practice Address - Country:US
Practice Address - Phone:847-520-7484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028265122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist