Provider Demographics
NPI:1699319723
Name:LUDWIKOWSKA, PATRICIA DOMINIKA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DOMINIKA
Last Name:LUDWIKOWSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6540 W IRVING PARK RD APT 206
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2468
Mailing Address - Country:US
Mailing Address - Phone:773-663-1060
Mailing Address - Fax:
Practice Address - Street 1:5352 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2316
Practice Address - Country:US
Practice Address - Phone:773-353-5047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020296363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily