Organization
ILLINOIS SPINAL & SPORTS REHABILITATION SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC JAMES LUKOSUS DC (PRESIDENT)
(630) 989-9700
Entity
Organization
Contact information
Practice address
3360 LACROSSE LN STE 116, NAPERVILLE, IL 60564-8155
(630) 904-9700
(630) 904-9713
Mailing address
3360 LACROSSE LN STE 116, NAPERVILLE, IL 60564-8155
(630) 904-9700
(630) 904-9713
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008240
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992774277
INDIVIDUAL NPI
IL
01
—
7553267
AETNA ID
IL
01
—
9932170
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/27/2007
Last updated
08/05/2024
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