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General NPI Number Information
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NPI Number | 1417202268
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Entity Type | Individual
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Provider Name | BETSY K LUKA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 4326 W MONTROSE AVE
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City | CHICAGO
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State | IL
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Zip | 60641-2016
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Country | US
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Telephone | 773-883-9100
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Fax | 773-883-0005
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Provider Business Mailing Address
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Address Line | 4326 W MONTROSE AVE
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City | CHICAGO
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State | IL
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Zip | 60641-2016
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Country | US
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Telephone | 773-883-9100
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Fax | 773-883-0005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 265725-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 051158
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036136306
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License Number State | IL
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