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Individual
DR. MARK T KLUCKA
Active
Individual
DR. MARK T KLUCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036077227
IL
207RG0100X
Gastroenterology Physician
036.077227
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077227
—
IL
01
—
100013015
RAILROAD MEDICARE
IL
Enumeration date
08/23/2006
Last updated
09/19/2025
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