MEDICARE: DR. PAUL R LUCAS DPM, FACFAS

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
1	213E00000X	Podiatrist	016004860	IL

General Provider Information

NPI Number	:	1497741508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL R LUCAS DPM, FACFAS

Provider Business Mailing Address
First Line	:	9400 S CICERO AVE STE 100
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-2536
Country	:	US
Telephone Number	:	708-424-3201
Fax Number	:	708-424-5001

Provider Business Practice Location Address
First Line	:	800 BIESTERFIELD RD STE 207
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3378
Country	:	US
Telephone Number	:	847-228-6543
Fax Number	:	847-577-3587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	05/18/2025

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