Healthcare Provider Details

I. General information

NPI: 1821730011
Provider Name (Legal Business Name): EVELYN CECILE LUNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 S PARK ST
MADISON WI
53715-1708
US

IV. Provider business mailing address

1102 S PARK ST
MADISON WI
53715-1708
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-3111
  • Fax: 608-263-6663
Mailing address:
  • Phone: 608-263-3111
  • Fax: 608-263-6663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number82862-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number82862-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: