Individual
FRED LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9933 LAWLER AVE, SKOKIE, IL 60077-3703
(847) 675-4867
Mailing address
701 THOMPSON BLVD, BUFFALO GROVE, IL 60089-1013
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
019023343
IL
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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