Active NPI
Jaclyn Lukjanowicz
- Developmental Therapist
- Lockport, IL
National Provider Identifier
1124658174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 1348 Tralee LN
Lockport, IL 60441-2670 - Phone
- (815) 323-3149
- NPI assigned
- Jan 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
1348 Tralee LN
Lockport, IL 60441-2670
Mailing address
1348 Tralee LN
Lockport, IL 60441-2670
Phone (815) 323-3149
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Lockport |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579219200000",
"number": "1124658174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1348 TRALEE LN",
"city": "LOCKPORT",
"state": "IL",
"postal_code": "604412670",
"telephone_number": "815-323-3149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1348 TRALEE LN",
"city": "LOCKPORT",
"state": "IL",
"postal_code": "604412670",
"telephone_number": "815-323-3149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUKJANOWICZ",
"first_name": "JACLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Lockport",
"affiliation": "N",
"address_1": "1348 Tralee Ln",
"city": "Lockport",
"state": "IL",
"country_code": "US",
"postal_code": "604412670",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lockport, IL
- Lockport Township Fire Protection District
- Lockport Township High School Dist 205
- Muhammed Longi, M.D.
- Adriana Lopez
- Gina D Lopresti, PMHNP
- Sanya Lulla, D.P.M
- Lutheran Social Services of Illinois
- Lutheran Social Services of Illinois
- Lymphedema Treatment and Wound Care Devices, LLC
- Julian Machado, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.