Healthcare Provider Details

I. General information

NPI: 1720401128
Provider Name (Legal Business Name): MARGARET J. LUKOMSKI MA, LCPC, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N WABASH AVE COURTYARD BUILDING
CHICAGO IL
60611-2514
US

IV. Provider business mailing address

730 N WABASH AVE COURTYARD BUILDING
CHICAGO IL
60611-2514
US

V. Phone/Fax

Practice location:
  • Phone: 312-573-8005
  • Fax: 312-573-7719
Mailing address:
  • Phone: 312-573-8005
  • Fax: 312-573-7719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number180001581
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: