Mr. Roger Alan Lucero
Geriatric Medicine
4001 W Devon Ave Ste. 207
Chicago
, Illinois 60646-4523
Mr. Roger Alan Lucero
Geriatric Medicine
4001 W Devon Ave Ste. 207
Chicago
, Illinois 60646-4523
(773) 930-4662
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Mr. Roger Alan Lucero
- 4001 W. Devon Ave. Suite 207
- Chicago, IL
- Zip : 60646
- Fax : (773) 930-4662
- Phone : (773) 930-4538
Second Address
- Mr. Roger Alan Lucero
- 4001 W Devon Ave Ste. 207
- Chicago, IL
- Zip : 60646-4523
- Fax : (773) 930-4662
- Phone : (773) 930-4538
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 36057435 | IL |
National Provider Identifier
| NPI | 1093851164 |
|---|---|
| Provider Name | Mr. Roger Alan Lucero |
| First Address | Chicago, IL 60646 |
| Second Address | Chicago, IL 60646-4523 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/01/2007 |
| Last Update Date | 29/04/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 36-057435 | (05) | IL |
| 364377050-60004-01 | (05) | IL |
| C43678 | (02) | IL |
| L81301 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.