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General NPI Number Information
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NPI Number | 1629664628
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Entity Type | Organization
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Legal Business Name | LOTUS SPEECH ACADEMY
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Dates
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Enumeration Date | 12/15/2020
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Last Update Date | 11/08/2025
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Provider Practice Location Address
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Address Line | 1580 N NORTHWEST HWY STE 305A
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City | PARK RIDGE
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State | IL
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Zip | 60068-1469
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Country | US
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Telephone | 312-401-2065
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Fax | 312-312-9598
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Provider Business Mailing Address
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Address Line | 7764 N NORA AVE
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City | NILES
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State | IL
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Zip | 60714-4740
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Country | US
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Telephone | 312-401-2065
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Fax | 312-312-9598
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Authorized Official
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Title or Position | OWNER
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Name | AGATA KUCZYNSKA
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Credential | M.A. CCC-SLP/L
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Telephone | 312-401-2065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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