MEDICARE: KATARZYNA LUC

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	224Z00000X	Occupational Therapy Assistant	057003403	IL

General Provider Information

NPI Number	:	1871069526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARZYNA LUC

Provider Business Mailing Address
First Line	:	535 S CLEVELAND AVE APT 408
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-2144
Country	:	US
Telephone Number	:	847-293-5117
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 S CLEVELAND AVE APT 408
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-2144
Country	:	US
Telephone Number	:	847-293-5117
Fax Number	:

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

Provider Enumeration Date	:	10/21/2018
Last Update Date	:	10/21/2018

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Directions to “ KATARZYNA LUC ” Practice Location

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