Provider Demographics
NPI:1902524093
Name:LUGONJA, BRANKA (APRN)
Entity Type:Individual
Prefix:
First Name:BRANKA
Middle Name:
Last Name:LUGONJA
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 1:840 WILLOW RD STE J
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-6823
Mailing Address - Country:US
Mailing Address - Phone:224-985-6863
Mailing Address - Fax:
Practice Address - Street 1:840 WILLOW RD STE J
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6823
Practice Address - Country:US
Practice Address - Phone:224-985-6863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10471-33363LF0000X
IL209.025608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily