Individual
CHRISTINE MARIE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
513 N MAIN ST, ANNA, IL 62906-1668
(618) 833-4471
(618) 833-6267
Mailing address
513 N MAIN ST, ANNA, IL 62906-1668
(618) 833-4471
(618) 833-6267
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-099486
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-099486
—
IL
01
—
036099486
IDPA FEE FOR SERVICE
IL
01
—
048870
HEALTH ALLIANCE
IL
01
—
415518
HEALTHLINK
IL
01
—
G96923
TRICARE
IL
Enumeration date
07/13/2005
Last updated
07/21/2022
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