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

Last updated

Oct 4, 2023By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 123 Pediatrics, S.C.

  dba 1-2-3 Pediatrics

  • 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": [],
    "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.