Provider Demographics
NPI:1598486128
Name:LAGOWSKA, MARIA (OTD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LAGOWSKA
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5464 W HIGGINS AVE APT 3S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2151
Mailing Address - Country:US
Mailing Address - Phone:773-526-2758
Mailing Address - Fax:
Practice Address - Street 1:5464 W HIGGINS AVE APT 3S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2151
Practice Address - Country:US
Practice Address - Phone:773-526-2758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015047225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics