Provider Demographics
NPI:1013116896
Name:LUGOWSKI, PATRICIA E (OT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:LUGOWSKI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-5425
Practice Address - Fax:708-684-3652
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056006163225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL600040OtherMEDICARE GROUP NUMBER
IL1619980OtherBCBS OF IL
IL599990OtherMEDICARE GROUP NUMBER
IL600000Medicare PIN
IL600000002Medicare PIN
ILK51821Medicare PIN
IL1619980OtherBCBS OF IL