NPI 1477129922

Jacob Stuart Joseph Lucero

Practitioner Radiologic Technologist North Chicago, IL

Practice location

Address: 2450 Buckley Rd, North Chicago, IL 60064-3092
Phone: (847) 688-1900
Mailing address: 855 Sanctuary Dr APT 303a, Lake Villa, IL 60046-7988

Registered specialties

Radiologic Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247100000X Licence 590484

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Registry record

NPI: 1477129922
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jun 2021
Record last updated: 3 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.