Provider Demographics
NPI:1093379109
Name:LUBIENIECKI, CHLOE M (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:M
Last Name:LUBIENIECKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:M
Other - Last Name:SUCHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:618 HINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2630
Mailing Address - Country:US
Mailing Address - Phone:847-630-6123
Mailing Address - Fax:
Practice Address - Street 1:618 HINGHAM LN
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2630
Practice Address - Country:US
Practice Address - Phone:847-630-6123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056012788225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist