Anne Havenga Lueken, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.025892 Issued in IL

Practice address

209 Rec Plex Dr
O Fallon, IL 62269-4327

Phone

(618) 624-3886

NPI assigned

May 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1487403713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 REC PLEX DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694327",
            "telephone_number": "618-624-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 REC PLEX DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694327",
            "telephone_number": "618-624-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEKEN",
        "first_name": "ANNE",
        "middle_name": "HAVENGA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2021029472",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Maria Lovell
• Nicole Lowrey, MD, PHD
• Shae Nicole Lowry
• Ashley Renee Luberda, RBT
• Alicia Lyn Luechtefeld, M.S. CCC-SLP
• Siyan Lumas, ED. S
• James Robert Lundy, MD
• Taylor'Jode Markeya Luster
• Lutheran Child and Family Service of Illinois
• Kelsey Dionna Lyles

• Physical Therapist in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.