Provider Demographics
NPI:1942049747
Name:LASZKIEWICZ, GRACE VICTORIA
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:VICTORIA
Last Name:LASZKIEWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10617 PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5138
Mailing Address - Country:US
Mailing Address - Phone:708-215-1627
Mailing Address - Fax:
Practice Address - Street 1:4885 HOFFMAN BLVD STE 400
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-3727
Practice Address - Country:US
Practice Address - Phone:847-645-1443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13936929-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist