Individual
DOROTA M. LUKASIEWICZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
925 N WESTERN AVE, CHICAGO, IL 60622-4777
(773) 227-5150
(773) 227-6670
Mailing address
925 N WESTERN AVE, CHICAGO, IL 60622-4777
(773) 227-5150
(773) 227-6670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1620435
BCBS PIN#
IL
Enumeration date
05/12/2006
Last updated
07/09/2007
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