Individual
DR. THOMAS A. LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
036112147
IL
207R00000X
Internal Medicine Physician
036112147
IL
207R00000X
Internal Medicine Physician
35087011
OH
207R00000X
Internal Medicine Physician
61085-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00480520
MEDICARE RAILROAD PTAN
IL
Enumeration date
09/24/2006
Last updated
08/20/2026
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