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Individual

MRS. MARY R LUKAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
926 SAINT JAMES PL, PARK RIDGE, IL 60068-4654
(847) 823-8350
Mailing address
150 WEILAND RD, BUFFALO GROVE, IL 60089-7047
(847) 465-0200

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001127
IL

Other

Enumeration date
12/05/2011
Last updated
12/05/2011
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