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General NPI Number Information
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NPI Number | 1801356761
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Entity Type | Individual
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Provider Name | LUKE HUNTER DANIEL DUDA MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 530 NE GLEN OAK AVE
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City | PEORIA
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State | IL
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Zip | 61637-0001
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Country | US
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Telephone | 217-372-5658
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Fax |
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Provider Business Mailing Address
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Address Line | 111 OAKWOOD RD
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City | EAST PEORIA
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State | IL
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Zip | 61611-1853
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Country | US
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Telephone | 309-740-4272
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | U9899
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036-167917
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License Number State | IL
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