MEDICARE: LUKE EDWARD MUZYKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	000000000000	IL

General Provider Information

NPI Number	:	1306697636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE EDWARD MUZYKA

Provider Business Mailing Address
First Line	:	6035 S MENARD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-4419
Country	:	US
Telephone Number	:	773-243-7062
Fax Number	:

Provider Business Practice Location Address
First Line	:	1041 N WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-6089
Country	:	US
Telephone Number	:	312-650-9132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2024
Last Update Date	:	03/27/2024

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Directions to “ LUKE EDWARD MUZYKA ” Practice Location

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