MEDICARE: LUBOWA N SHIMONDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1043886674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUBOWA N SHIMONDE

Provider Business Mailing Address
First Line	:	1705 W CHARIOT CT APT 1B
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-5533
Country	:	US
Telephone Number	:	224-762-9823
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 W CHARIOT CT APT 1B
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-5533
Country	:	US
Telephone Number	:	224-762-9823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2021
Last Update Date	:	09/26/2025

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Directions to “ LUBOWA N SHIMONDE ” Practice Location

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