Provider Demographics
NPI:1720448855
Name:LOPINA HOME THERAPY
Entity Type:Organization
Organization Name:LOPINA HOME THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPINA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-743-6619
Mailing Address - Street 1:606 CAMBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-0525
Mailing Address - Country:US
Mailing Address - Phone:708-743-6619
Mailing Address - Fax:815-744-2646
Practice Address - Street 1:606 CAMBRIDGE LN
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404-0525
Practice Address - Country:US
Practice Address - Phone:708-743-6619
Practice Address - Fax:815-744-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.012932225100000X
IL146.007339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty