Healthcare Provider Details

I. General information

NPI: 1508770538
Provider Name (Legal Business Name): LUUMD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

879 S POPLAR AVE
ELMHURST IL
60126-4548
US

IV. Provider business mailing address

879 S POPLAR AVE
ELMHURST IL
60126-4548
US

V. Phone/Fax

Practice location:
  • Phone: 312-952-4998
  • Fax:
Mailing address:
  • Phone: 312-952-4998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MINH LUU
Title or Position: PRINCIPAL
Credential: MD
Phone: 312-952-4998