=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679453898
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUKE WALKER KOHNE LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2025
-----------------------------------------------------
Last Update Date | 09/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5600 N RIDGE AVE UNIT 105
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60660-0097
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-717-5457
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 426 S MAIN ST
-----------------------------------------------------
City | MONTGOMERY
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60538-1414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 178.021980
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------