Individual
MISS LORI ANN HAVELKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8131 MONTICELLO AVE, SKOKIE, IL 60076-3325
(847) 673-6767
Mailing address
5436 S LATROBE AVE, CHICAGO, IL 60638-2910
(872) 800-4385
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.001163
IL
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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