Provider Demographics
NPI:1083836571
Name:DUFFY, LUCELITA ABAD (PT)
Entity Type:Individual
Prefix:MRS
First Name:LUCELITA
Middle Name:ABAD
Last Name:DUFFY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1525
Mailing Address - Country:US
Mailing Address - Phone:708-386-5858
Mailing Address - Fax:
Practice Address - Street 1:7411 LAKE STREET
Practice Address - Street 2:REHABILITATION & SPORTS MEDICINE WEST SUBURBAN RESURREC
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305
Practice Address - Country:US
Practice Address - Phone:708-488-1700
Practice Address - Fax:708-488-2391
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist