Healthcare Provider Details

I. General information

NPI: 1982191862
Provider Name (Legal Business Name): AMAN LUTHRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date: 11/28/2018
Reactivation Date: 12/17/2018

III. Provider practice location address

20201 CRAWFORD AVE
OLYMPIA FIELDS IL
60461-1010
US

IV. Provider business mailing address

20201 CRAWFORD AVE
OLYMPIA FIELDS IL
60461-1010
US

V. Phone/Fax

Practice location:
  • Phone: 708-747-4000
  • Fax:
Mailing address:
  • Phone: 708-747-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01097165A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-48136
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036176760
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036176760
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: