Organization
RENEE LUBURIC MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE LUBURIC MD (OWNER)
(206) 949-9521
Entity
Organization
Contact information
Practice address
2500 W BRADLEY PL STE 100, CHICAGO, IL 60618-4716
(773) 649-0759
Mailing address
2500 W BRADLEY PL STE 100, CHICAGO, IL 60618-4716
(773) 649-0759
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14929569
CAQH
IL
Enumeration date
08/12/2020
Last updated
08/12/2020
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