MEDICARE: PAUL S LUNING MD

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	207Q00000X	Family Medicine Physician	036097819	IL

Other Identifiers

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

General Provider Information

NPI Number	:	1851356414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL S LUNING MD

Provider Business Mailing Address
First Line	:	14 W LAKE ST
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2606
Country	:	US
Telephone Number	:	708-383-0113
Fax Number	:	708-383-9911

Provider Business Practice Location Address
First Line	:	14 W LAKE ST
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2606
Country	:	US
Telephone Number	:	708-383-0113
Fax Number	:	708-383-9911

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	12/26/2019

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