NPIMap

Organization Active NPI

Martin G Luken III MD SC

  • Neurological Surgery Physician
  • Harvey, IL
National Provider Identifier
1639303795
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036-051447 Issued in IL
Legal business name
MARTIN G LUKEN III MD SC
Practice address
71 W 156TH St
Suite 205
Harvey, IL 60426-4260
Phone
(708) 596-3344
NPI assigned
May 5, 2009
Last updated
Nov 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Martin G Luken III, MDNPI 1326013392
Title
President
Phone
(708) 596-3344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036-051447 IL Primary

Addresses

Primary practice location

71 W 156TH St
Suite 205
Harvey, IL 60426-4260

Mailing address

PO Box 429
Matteson, IL 60443-0429
Phone (708) 747-5850

Other identifiers 3

IdentifierTypeStateIssuer
0001629760OtherILBCBS
DP4714OtherILRR MEDICARE
036051447MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1639303795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430429",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 W 156TH ST",
            "address_2": "SUITE 205",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264260",
            "telephone_number": "708-596-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN G LUKEN III MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "LUKEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-596-3344",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036-051447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001629760",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DP4714",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051447",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.