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NPI Code Detail

MEDICARE: DR. BRIAN JOSEPH LUC M.D.

MEDICARE: DR. BRIAN JOSEPH LUC M.D.
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
1207R00000XInternal Medicine Physician036135556IL

General Provider Information

NPI Number : 1376833657
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN JOSEPH LUC M.D.
Provider Business Mailing Address
First Line : PO BOX 746715
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6715
Country : US
Telephone Number : 773-352-1515
Fax Number : 312-929-0373
Provider Business Practice Location Address
First Line : 3348 W 87TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-3767
Country : US
Telephone Number : 773-776-4471
Fax Number : 773-564-3510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2011
Last Update Date : 06/09/2025

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