Healthcare Provider Details
I. General information
NPI: 1093629370
Provider Name (Legal Business Name): MAGDALENA ZOFIA LIJOWSKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4141 N KEDZIE AVE STE 2
CHICAGO IL
60618-2479
US
IV. Provider business mailing address
4141 N KEDZIE AVE STE 2
CHICAGO IL
60618-2479
US
V. Phone/Fax
- Phone: 773-754-0577
- Fax:
- Phone: 773-754-0577
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: