MRS. ANNE B. LUCKOSE


Address: 1052 W. Loyola Avenue, Chicago, IL 60626
Phone: 7735082540

MRS. ANNE B. LUCKOSE (NPI# 1609015510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609015510
Entity Type Individual
Full Name MRS. ANNE B. LUCKOSE
Credential APN, NP-C
Practice Address 1052 W. Loyola Avenue
Chicago
IL 60626
Mailing Address 1052 W Loyola Ave
Chicago
IL 60626-5206
Practice Telephone 7735082540
Practice Fax Number 7735082242
Mailing Telephone 7735082540
Mailing Fax Number 7735082242
Enumeration Date 2009-02-17
Last Update Date 2013-01-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
041340115 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL IL STATE LICENSE 041340115 01

Office Location

Street Address 1052 W. LOYOLA AVENUE
City CHICAGO
State IL
Zip Code 60626

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1457718124 Carol L. Marshall Social Worker 7231 1/2 N. Sheridan Rd, Chicago, IL 60626 2016-01-26
1972948206 Donna Darcell Smith Counselor 1401 West Jarvis Ave., #2e, Chicago, IL 60626 2013-04-30
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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1942796123 Elizabeth R Reyna Nurse Practitioner 5841 S Maryland Ave # Mc7120, Chicago, IL 60637-1443 2018-07-10
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1942717418 Madiha Khan Nurse Practitioner 3000 N Halsted St Ste 623, Chicago, IL 60657 2018-01-05
1952828980 Paulina Petrishka Nurse Practitioner 1115 N Crosby St # C, Chicago, IL 60610-2405 2017-08-30
1831639384 Ivory Rhymes Nurse Practitioner 8750 W Bryn Mawr Ave, Chicago, IL 60631-3655 2017-03-02
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1093253718 Daniel Robert Mead Nurse Practitioner 1540 W Chicago Ave, Chicago, IL 60642-5236 2017-02-01
1992249585 Karen Panganiban Nurse Practitioner 4605 N Elston Ave, 3a, Chicago, IL 60630-4373 2016-12-15
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Competitor

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City CHICAGO
Zip Code 60626

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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