Provider Demographics
NPI:1437604568
Name:OBROCHTA, LUKASZ (LCSW)
Entity type:Individual
Prefix:
First Name:LUKASZ
Middle Name:
Last Name:OBROCHTA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 MULLINGAR CT
Mailing Address - Street 2:1B
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-5614
Mailing Address - Country:US
Mailing Address - Phone:847-401-9564
Mailing Address - Fax:
Practice Address - Street 1:4121 W LAKE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-1719
Practice Address - Country:US
Practice Address - Phone:312-405-3557
Practice Address - Fax:773-826-2109
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0186101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical