| Doctor Name: | MRS. MARY ANN PAWELKO |
| NPI Number: | 1942440557 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, CADC |
| License Number: | 23564 |
| Business Practice Address: | 217 Goodnow Blvd Round Lake, IL - 600733217 |
| Business Phone Number: | 8472232561 |
| Business Fax Number: | 8472453573 |
| Mailing Address: | 2213 N Sunrise Dr, ROUND LAKE BEACH |
| State: | IL |
| Postal Code: | 600734049 |
| Phone Number: | 8472232561 |
| Fax Number: | 8472453573 |
| NPI Enumeration Date: | 02/23/2009 |
| NPI Last Update Date: | 02/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 23564 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |