MEDICARE: LUCERO MOLINA RD

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	133V00000X	Registered Dietitian	164.007493	IL

General Provider Information

NPI Number	:	1639652787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCERO MOLINA RD

Provider Business Mailing Address
First Line	:	619 W JACKSON BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-5606
Country	:	US
Telephone Number	:	312-627-0444
Fax Number	:	312-648-0155

Provider Business Practice Location Address
First Line	:	619 W JACKSON BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-5606
Country	:	US
Telephone Number	:	312-627-0444
Fax Number	:	312-648-0155

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

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	09/13/2018

Similar Medicare Providers

1033596440 — FITNESS FORMULA, LTD
Practice Location Address:

619 W JACKSON BLVD
CHICAGO, IL
60661-5606

Practice Phone: 312-648-4666
Practice Fax: 312-648-0155

1548794704 — SARAH SOBOTKA
Practice Location Address:

619 W JACKSON BLVD
CHICAGO, IL
60661-5606

Practice Phone: 312-627-0444
Practice Fax: 312-648-0155

1407947229 — YOUNG KIM M.D.
Practice Location Address:

3606 W LAWRENCE AVE
CHICAGO, IL
60625-5606

Practice Phone: 773-583-4122
Practice Fax: 773-596-5397

1811082514 — HEALTHFRONT LTD
Practice Location Address:

3610 W LAWRENCE AVE
CHICAGO, IL
60625-5606

Practice Phone: 773-267-0055
Practice Fax: 773-267-1992

1306902689 — MICHAEL DEVITO LMFT
Practice Location Address:

3010 W CORNELIA AVE
CHICAGO, IL
60618-5606

Practice Phone: 415-250-7490
Practice Fax:

1649466426 — HEALTHFRONT, LIMITED
Practice Location Address:

3610 W LAWRENCE AVE
CHICAGO, IL
60625-5606

Practice Phone: 773-267-1992
Practice Fax:

Directions to “ LUCERO MOLINA RD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.