Provider Demographics
NPI:1346393998
Name:LUKAS, CHERYL A (OT)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:LUKAS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4220 FAWN CT
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-4783
Mailing Address - Country:US
Mailing Address - Phone:815-462-4928
Mailing Address - Fax:815-462-4929
Practice Address - Street 1:14409 EDISON DR
Practice Address - Street 2:UNIT 1
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-3670
Practice Address - Country:US
Practice Address - Phone:815-462-4928
Practice Address - Fax:815-462-4929
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist