Provider Demographics
NPI:1194441212
Name:LUKAWIECKA, AGNIESZKA (APRN)
Entity type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:LUKAWIECKA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W. HIGGINS RD.
Mailing Address - Street 2:SUITE 440
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169
Mailing Address - Country:US
Mailing Address - Phone:847-839-0400
Mailing Address - Fax:847-839-0800
Practice Address - Street 1:2500 W. HIGGINS RD. BEDROSE PEDIATRICS S.C.
Practice Address - Street 2:SUITE 440
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-839-0400
Practice Address - Fax:847-839-0800
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022848208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics