Provider Demographics
NPI:1447006507
Name:GAWRON, KAROLINA TERESA (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:KAROLINA
Middle Name:TERESA
Last Name:GAWRON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6347 W ROSCOE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4049
Mailing Address - Country:US
Mailing Address - Phone:773-987-5585
Mailing Address - Fax:
Practice Address - Street 1:263 DENNIS LN
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-1319
Practice Address - Country:US
Practice Address - Phone:773-330-9348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015607225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist