Martie Ryan Lukanich Psy D PC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MARTIE RYAN LUKANICH PSY D PC

Practice address

9631 W 153Rd St Ste 37
Orland Park, IL 60462-3778

Phone

(708) 829-8277

NPI assigned

Sep 10, 2021

Organization subpart

No

Locations

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

Authorized official

Name

Martie Ryan Lukanich, PSYD

Title

President

Phone

(708) 829-8277

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1508535618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 BELL AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605255903",
            "telephone_number": "708-829-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 W 153RD ST STE 37",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623778",
            "telephone_number": "708-829-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIE RYAN LUKANICH PSY D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "LUKANICH",
        "authorized_official_first_name": "MARTIE",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-829-8277",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497886196",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740403476",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn A Marnell, FNP-C
• Silvio Marra, MD
• Robert K Marshall, PH.D.
• Robert Q Marshall, DDS
• Roseann Martarano, LCSW
• Amanda Martin, OTR/L
• Charles Franklin Martin I, MD, FACEP
• Helen Gartner Martin, M.M.
• Jasmine Martin
• Nya Martin, LCSW

• All providers in Orland Park, IL
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.