Provider Demographics
NPI:1174885313
Name:LECHOWICZ, LAUREN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LECHOWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3056 W BERTEAU AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-2543
Mailing Address - Country:US
Mailing Address - Phone:773-213-1469
Mailing Address - Fax:
Practice Address - Street 1:2013 W 17TH ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1814
Practice Address - Country:US
Practice Address - Phone:312-725-4090
Practice Address - Fax:312-268-5388
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILL22053485736222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist