Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 024011 | LA |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 036.122377 | IL |
NPI | 1801857545 |
---|---|
Provider Name | Dr. James B Lucas II |
First Address | Chicago, IL 60612-7242 |
Second Address | Chicago, IL 60612-7242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 20/04/2009 |