Healthcare Provider Details

I. General information

NPI: 1346358033
Provider Name (Legal Business Name): LUZ A. FELDMANN, M.D., LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W CENTRAL RD SUITE 307
ARLINGTON HEIGHTS IL
60005-2402
US

IV. Provider business mailing address

1595 MOMENTUM PL
CHICAGO IL
60689-5315
US

V. Phone/Fax

Practice location:
  • Phone: 847-255-7246
  • Fax: 847-255-6231
Mailing address:
  • Phone: 847-677-6410
  • Fax: 847-677-6420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number036081866
License Number StateIL

VIII. Authorized Official

Name: LUZ A FELDMANN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-255-7246