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Individual

BETSY K LUKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4326 W MONTROSE AVE, CHICAGO, IL 60641-2016
(773) 883-9100
(773) 883-0005
Mailing address
4326 W MONTROSE AVE, CHICAGO, IL 60641-2016
(773) 883-9100
(773) 883-0005

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036136306
IL
207Q00000X
Family Medicine Physician
051158
CT
207Q00000X
Family Medicine Physician
265725-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036136306
IL
Enumeration date
07/18/2012
Last updated
02/17/2020
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