Provider Demographics
NPI:1427172758
Name:LODOWSKY, CHRISTOPHER MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:LODOWSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22285 N. PEPPER ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2540
Mailing Address - Country:US
Mailing Address - Phone:847-382-5080
Mailing Address - Fax:
Practice Address - Street 1:22285 N. PEPPER ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2540
Practice Address - Country:US
Practice Address - Phone:847-382-5080
Practice Address - Fax:847-382-0923
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223105208800000X
IL036126714208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036126712Medicaid
IL036126712Medicaid