Provider Demographics
NPI:1710215678
Name:LUSZCZ, PAULA ANN (MA, MPH)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANN
Last Name:LUSZCZ
Suffix:
Gender:F
Credentials:MA, MPH
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:ANN
Other - Last Name:LUSZCZ-BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MPH
Mailing Address - Street 1:1304 PATRICK DR
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1091
Mailing Address - Country:US
Mailing Address - Phone:847-837-0102
Mailing Address - Fax:
Practice Address - Street 1:1304 PATRICK DR
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1091
Practice Address - Country:US
Practice Address - Phone:847-837-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist