Jane F Luecking, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036090215 Issued in IL

Practice address

1790 Nations Dr
Suite 106
Gurnee, IL 60031-9164

Phone

(847) 244-9740

Fax

(847) 244-9870

NPI assigned

Aug 16, 2005

Last updated

Sep 10, 2008By the provider in NPPES

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Kenosha Pathology Consultants

  • Anatomic Pathology & Clinical Pathology Physician
  • Kenosha, WI
  • NPI 1790812857
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1407848617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 NATIONS DR",
            "address_2": "SUITE 106",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319164",
            "telephone_number": "847-244-9740",
            "fax_number": "847-244-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 NATIONS DR",
            "address_2": "SUITE 106",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319164",
            "telephone_number": "847-244-9740",
            "fax_number": "847-244-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUECKING",
        "first_name": "JANE",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036090215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R02237",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090215",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35307300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Losch, PT
• Wendy Jane Lotts, MD
• Madeline Lowe
• Tiffany Lowery
• Alexandra Loza, RBT
• Sue Aileen Lutz, PT
• Luxottica of America Inc (Oakley B056)
• Luxottica of America Inc (For Eyes (Cm264))
• Luxottica of America Inc. (Lenscrafters #2724)
• Luxottica Retail North America Inc (Sears Optical #C1154)

• Family Medicine Physician in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.