Healthcare Provider Details

I. General information

NPI: 1558152561
Provider Name (Legal Business Name): KAROLINA LEWCZUK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY OF NEW MEXICO MSC10550
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

2602 N 74TH CT APT 2
ELMWOOD PARK IL
60707-1893
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-4661
  • Fax:
Mailing address:
  • Phone: 773-584-1771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRS2025-0135
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: