Provider Demographics
NPI:1013794528
Name:STREMPLEWSKI, LARA MARIE
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:MARIE
Last Name:STREMPLEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16119 DREXEL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1643
Mailing Address - Country:US
Mailing Address - Phone:708-289-4548
Mailing Address - Fax:
Practice Address - Street 1:16119 DREXEL AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-1643
Practice Address - Country:US
Practice Address - Phone:708-289-4548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer