Healthcare Provider Details

I. General information

NPI: 1427945401
Provider Name (Legal Business Name): LUMICLINICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2025
Last Update Date: 06/21/2025
Certification Date: 06/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 PATRIOT BLVD STE 250
GLENVIEW IL
60026-8021
US

IV. Provider business mailing address

2700 PATRIOT BLVD STE 250
GLENVIEW IL
60026-8021
US

V. Phone/Fax

Practice location:
  • Phone: 847-769-4500
  • Fax: 847-787-1740
Mailing address:
  • Phone: 847-769-4500
  • Fax: 847-787-1740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN CHARVET
Title or Position: FOUNDER
Credential: APRN
Phone: 847-907-0660