Individual
MRS. SHANNON LEE LUCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
515 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1003
(574) 232-2037
Mailing address
1531 S HALSTED ST UNIT 301, CHICAGO, IL 60607-5135
(989) 482-7696
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Enumeration date
07/12/2013
Last updated
03/04/2019
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