Individual
RYAN LUSTENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1256
(708) 923-4000
Mailing address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1256
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036134590
IL
207L00000X
Anesthesiology Physician
125059189
IL
Other
Enumeration date
06/22/2011
Last updated
07/12/2021
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