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MACKENZIE ANN LULLO AS, BAS, PTA
NPI 1063145712
Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine in Wauconda, IL

Active since July 08, 2022
23525 W MILTON RD, WAUCONDA, IL 60084(847) 438-5400 Get Directions Write a Review

NPPES record last updated: July 8, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mackenzie Ann Lullo As, Bas, Pta NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACKENZIE ANN LULLO AS, BAS, PTA (NPI 1063145712) is an individual pediatric rehabilitation medicine provider in Wauconda, Illinois, licensed in Illinois (160.009537) and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1063145712
Entity TypeIndividualFemale
Primary Taxonomy2081P0010X
Provider Legal NameMACKENZIE ANN LULLOCredential: AS, BAS, PTA
Location Address23525 W MILTON RDWauconda, IL 60084-2619
Mailing Address1513 Evergreen StHoliday Hills, IL 60051-9128 · (815) 861-0856
Phone(847) 438-5400
Sole ProprietorNo
Enumeration DateJuly 8, 2022
NPPES CertifiedJuly 8, 2022
✔ NPI 1063145712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pediatric Rehabilitation MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P0010X
License✔ Licensed in IL · 160.009537
Definition
A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care.
23525 W MILTON RD, Wauconda, IL 60084
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Other Identifiers 1

Other1003094996IL · Pediatrics In Motion

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN LEIGH WURZBACH
Occupational Therapist
23525 W MILTON RD
WAUCONDA, IL 60084
Lake County (847) 438-5400
ABIGAIL SWIDERGAL COTA/L
Occupational Therapy Assistant
23525 W MILTON RD
WAUCONDA, IL 60084
Lake County (847) 226-1300
SANTINA BRANCH COTA
Occupational Therapy Assistant
23525 W MILTON RD
WAUCONDA, IL 60084
Lake County (847) 438-5400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mackenzie Lullo's NPI number?

The NPI number for Mackenzie Lullo is 1063145712. It was assigned to this individual provider in the NPPES registry on July 8, 2022.

Where is Mackenzie Lullo located?

Mackenzie Lullo practices at 23525 W Milton Rd, Wauconda, IL 60084. The listed phone number is (847) 438-5400.

What is Mackenzie Lullo's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pediatric Rehabilitation Medicine, with taxonomy code 2081P0010X.

When was this NPI record last updated?

The NPPES record for Mackenzie Lullo was last updated on July 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.