Provider Demographics
NPI:1699100156
Name:LAZARCZUK, KATARZYNA M (PT)
Entity type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:M
Last Name:LAZARCZUK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 SILVERWOOD CT
Mailing Address - Street 2:C 2
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193
Mailing Address - Country:US
Mailing Address - Phone:630-307-0200
Mailing Address - Fax:312-377-1664
Practice Address - Street 1:2190 GLEDSTONE DRIVE
Practice Address - Street 2:UNIT B
Practice Address - City:GLENDALE HEIGHTS,
Practice Address - State:IL
Practice Address - Zip Code:60139
Practice Address - Country:US
Practice Address - Phone:630-307-0200
Practice Address - Fax:312-377-1664
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.019061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist