Agnieszka Lukacz
Individual provider Active NPI Massage Therapist · Kildeer, IL
NPI 1023834728 · NPPES record last updated Nov 26, 2024
Key facts
- NPI
- 1023834728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227022067 (IL)
- Practice address
- 20505 N Rand Rd
Kildeer, IL 60047-3004 - Phone
- (847) 481-8728
- Fax
- (312) 268-6118
- NPI assigned
- Nov 26, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227022067 | IL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Wellness LLC | Past | Accepting new patients | |
| Active Wellness, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227022067 | IL | Yes |
Addresses
Primary practice location
20505 N Rand Rd
Kildeer, IL 60047-3004
Mailing address
4555 N Lincoln Ave
Chicago, IL 60625-2102
Phone (847) 481-8728
Other practice location 1
40 N Northwest Hwy
Park Ridge, IL 60068-3329
Phone (847) 737-1023
Other providers in Kildeer, IL
- Anna Kawa
- Fatima Mustafa Klassman
- Lake Cook Chiropractic Health Care, Inc.
- Joseph Daniel Lamplot
- Julia Leonard
- Lumen Optical Illinois 1, LLC
- Jacob Padraig Reilley Luther
- Medical Testing Inc
- Gillian Messinger
- William Henry Neal
All providers in Kildeer, IL · Massage Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.