Provider Demographics
NPI:1699544965
Name:PAWLAK, ALEC (DC)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:PAWLAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 N CIRCLE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-2132
Mailing Address - Country:US
Mailing Address - Phone:219-363-1566
Mailing Address - Fax:
Practice Address - Street 1:923 S RANDALL RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1556
Practice Address - Country:US
Practice Address - Phone:630-517-5788
Practice Address - Fax:630-912-3702
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.014089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor