Healthcare Provider Details

I. General information

NPI: 1871423160
Provider Name (Legal Business Name): SARAH LUTGEN MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 N CLARK ST
CHICAGO IL
60614-2730
US

IV. Provider business mailing address

7438 N OKETO AVE
CHICAGO IL
60631-4429
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-6217
  • Fax: 312-227-9404
Mailing address:
  • Phone: 630-445-3996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041393211
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: