Provider Demographics
NPI:1467849075
Name:LANKO, MALGORZATA (LMT)
Entity Type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:
Last Name:LANKO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2068
Mailing Address - Country:US
Mailing Address - Phone:847-671-0555
Mailing Address - Fax:847-671-0685
Practice Address - Street 1:3545 ROSE ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2068
Practice Address - Country:US
Practice Address - Phone:847-671-0555
Practice Address - Fax:847-671-0685
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227003222225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist