Individual
MICHELE LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 N LECLAIRE AVE STE 100, CHICAGO, IL 60644-4104
(630) 886-2197
Mailing address
17 N LECLAIRE AVE STE 100, CHICAGO, IL 60644-4104
(630) 886-2197
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041323989
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
03/26/2022
Last updated
03/26/2022
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