Provider Demographics
NPI:1578690061
Name:GRABOWSKI, LISA ANN (DPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:67 W JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3507
Practice Address - Country:US
Practice Address - Phone:312-386-1100
Practice Address - Fax:312-386-1200
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1619980OtherBCBS OF IL
IL567700Medicare PIN
IL568080Medicare PIN
ILK52265Medicare PIN
IL1619980OtherBCBS OF IL
IL568150Medicare UPIN
ILK52266Medicare PIN