Provider Demographics
NPI:1073968012
Name:LENART, AGNIESZKA DOMINIKA
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:DOMINIKA
Last Name:LENART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7170 W GRAND AVE
Mailing Address - Street 2:APT 4E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-2862
Mailing Address - Country:US
Mailing Address - Phone:773-971-6277
Mailing Address - Fax:
Practice Address - Street 1:7170 W GRAND AVE
Practice Address - Street 2:APT 4E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-2862
Practice Address - Country:US
Practice Address - Phone:773-971-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant