Provider Demographics
NPI:1861611345
Name:POPRAWSKI, TERESA J (MD)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:J
Last Name:POPRAWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1100 JORIE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2219
Mailing Address - Country:US
Mailing Address - Phone:847-877-0454
Mailing Address - Fax:630-974-6602
Practice Address - Street 1:1100 JORIE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2219
Practice Address - Country:US
Practice Address - Phone:847-877-0454
Practice Address - Fax:630-974-6602
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-1157662084N0402X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209551OtherGROUP NUMBER
IL216421OtherMEDICARE GROUP
IL209551OtherGROUP NUMBER
ILK40622Medicare PIN