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NPI Code Detail

MEDICARE: LUKE C TANABE PA-C

MEDICARE: LUKE C TANABE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085011696IL

General Provider Information

NPI Number : 1356235576
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKE C TANABE PA-C
Provider Business Mailing Address
First Line : 800 N WESTMORELAND RD STE 100
Second Line :
City : LAKE FOREST
State : IL
Zip : 60045-1671
Country : US
Telephone Number : 847-535-7657
Fax Number : 224-271-4600
Provider Business Practice Location Address
First Line : 800 N WESTMORELAND RD STE 100
Second Line :
City : LAKE FOREST
State : IL
Zip : 60045-1671
Country : US
Telephone Number : 847-535-7657
Fax Number : 224-271-4600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2025
Last Update Date : 12/09/2025

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Directions to “ LUKE C TANABE PA-C” Practice Location

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