Organization
MARTIN G LUKEN III MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN G LUKEN III MD (PRESIDENT)
(708) 596-3344
Entity
Organization
Contact information
Practice address
71 W 156TH ST, SUITE 205, HARVEY, IL 60426-4260
(708) 596-3344
Mailing address
PO BOX 429, MATTESON, IL 60443-0429
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036-051447
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001629760
BCBS
IL
05
—
036051447
—
IL
01
—
DP4714
RR MEDICARE
IL
Enumeration date
05/05/2009
Last updated
11/25/2009
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