MEDICARE: LEA K LUA MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician	036094844	IL
2	2080P0203X	Pediatric Critical Care Medicine Physician	36501	WI
3	2080P0203X	Pediatric Critical Care Medicine Physician	ME89748	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1538144282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEA K LUA MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:	847-733-5315

Provider Business Practice Location Address
First Line	:	801 S WASHINGTON ST
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-7430
Country	:	US
Telephone Number	:	630-527-3136
Fax Number	:	630-527-3450

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	04/16/2026

801 S WASHINGTON ST FL 3
NAPERVILLE, IL
60540-7430

Practice Phone: 630-527-5359
Practice Fax: 630-527-5526