Lauren Bakula

Individual provider Active NPI Physical Therapist · Morton Grove, IL

NPI 1013356765 · NPPES record last updated Mar 17, 2016

Key facts

NPI
1013356765
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
9000 Waukegan Rd
Suite 100
Morton Grove, IL 60053-2127
Phone
(847) 779-6050
Fax
(847) 929-1167
NPI assigned
Jun 17, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

9000 Waukegan Rd
Suite 100
Morton Grove, IL 60053-2127

Mailing address

900 Rand Rd
Suite 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Other providers in Morton Grove, IL

All providers in Morton Grove, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.