Healthcare Provider Details

I. General information

NPI: 1225973795
Provider Name (Legal Business Name): EMMA KRYSTYNA LORENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 W SALT CREEK LN STE 350
ARLINGTON HEIGHTS IL
60005-5000
US

IV. Provider business mailing address

1550 SANDPEBBLE DR APT 203
WHEELING IL
60090-5921
US

V. Phone/Fax

Practice location:
  • Phone: 877-486-4140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-508993
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: