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General NPI Number Information
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NPI Number | 1437604568
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Entity Type | Individual
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Provider Name | LUKASZ OBROCHTA LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 08/18/2016
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Provider Practice Location Address
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Address Line | 4121 W LAKE ST
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City | CHICAGO
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State | IL
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Zip | 60624-1719
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Country | US
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Telephone | 312-405-3557
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Fax | 773-826-2109
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Provider Business Mailing Address
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Address Line | 116 MULLINGAR CT 1B
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City | SCHAUMBURG
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State | IL
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Zip | 60193-5614
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Country | US
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Telephone | 847-401-9564
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.018610
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License Number State | IL
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