MEDICARE: ST LUKE'S HEALTH RESOURCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	235Z00000X	Speech-Language Pathologist
3	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1275575805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST LUKE'S HEALTH RESOURCES

Provider Business Mailing Address
First Line	:	2720 STONE PARK BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3734
Country	:	US
Telephone Number	:	712-279-3380
Fax Number	:	712-279-7015

Provider Business Practice Location Address
First Line	:	4230 HICKORY LN
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-4604
Country	:	US
Telephone Number	:	712-274-0034
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MARK A JOHNSON
Credential	:
Telephone Number	:	712-279-3934

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	09/11/2025

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Directions to “ST LUKE'S HEALTH RESOURCES ” Practice Location

Language	Start Address	Practice Location

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