Basic Information
| Provider Information | |||||||||
| NPI: | 1134581739 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEILL | ||||||||
| FirstName: | LUKE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 E ONTARIO ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606113468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129269512 | ||||||||
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| Practice Location | |||||||||
| Address1: | 211 E ONTARIO ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606113468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129269512 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2016 | ||||||||
| LastUpdateDate: | 07/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 125.068510 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 036148129 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.