Kevin Lue, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-107913 Issued in IL

Practice address

3925 75TH St Ste 105
Aurora, IL 60504-7962

Phone

(630) 978-7337

Fax

(630) 978-1341

NPI assigned

Jun 18, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 123 Pediatrics, S.C.

  • Pediatrics Physician
  • Aurora, IL
  • NPI 1609957018
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1043255672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 75TH ST STE 105",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047962",
            "telephone_number": "630-978-7337",
            "fax_number": "630-978-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 75TH ST STE 105",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047962",
            "telephone_number": "630-978-7337",
            "fax_number": "630-978-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUE",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-107913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107913",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimber Lubert
• Keva Lucas, LCSW
• Michael Lucas
• Anetrice Luckett
• Kaley Ludvigsen
• Judy Luetkens, NP
• Jill Anne Luminais
• Selina Lundquist-Ochoa
• Lune Medical Group LTD
• Lutheran Child and Family Services of Illinois

• Pediatrics Physician in Aurora, IL
• Providers in Aurora, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.