Provider Demographics
NPI:1023768983
Name:LEWANDOWSKI, LORI ANN (PT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:HUDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:11133 S SAWYER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2723
Mailing Address - Country:US
Mailing Address - Phone:773-450-7861
Mailing Address - Fax:
Practice Address - Street 1:11133 S SAWYER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2723
Practice Address - Country:US
Practice Address - Phone:773-450-7861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-012705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist