Provider Demographics
NPI:1306406400
Name:CHAJA, SANDRA LUCILLE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LUCILLE
Last Name:CHAJA
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11915 SALYER DR
Mailing Address - Street 2:
Mailing Address - City:WHEATFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46392-7405
Mailing Address - Country:US
Mailing Address - Phone:219-299-9039
Mailing Address - Fax:
Practice Address - Street 1:1701 S CREASY LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4972
Practice Address - Country:US
Practice Address - Phone:765-502-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer