Individual
JANE F LUECKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1790 NATIONS DR, SUITE 106, GURNEE, IL 60031-9164
(847) 244-9740
(847) 244-9870
Mailing address
1790 NATIONS DR, SUITE 106, GURNEE, IL 60031-9164
(847) 244-9740
(847) 244-9870
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036090215
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090215
—
IL
05
—
35307300
—
WI
01
—
R02237
MEDICARE PTAN
IL
Enumeration date
08/16/2005
Last updated
09/10/2008
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