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General NPI Number Information
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NPI Number | 1497741508
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Entity Type | Individual
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Provider Name | PAUL R LUCAS DPM, FACFAS
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 05/18/2025
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Provider Practice Location Address
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Address Line | 800 BIESTERFIELD RD STE 207
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3378
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Country | US
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Telephone | 847-228-6543
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Fax | 847-577-3587
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Provider Business Mailing Address
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Address Line | 9400 S CICERO AVE STE 100
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City | OAK LAWN
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State | IL
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Zip | 60453-2536
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Country | US
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Telephone | 708-424-3201
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Fax | 708-424-5001
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016004860
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License Number State | IL
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