Provider Demographics
NPI:1225060965
Name:LUVISON, JAMES D (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:LUVISON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-0454
Mailing Address - Country:US
Mailing Address - Phone:847-590-5606
Mailing Address - Fax:847-590-5609
Practice Address - Street 1:1116 W NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2214
Practice Address - Country:US
Practice Address - Phone:847-590-5606
Practice Address - Fax:847-590-5609
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000461213E00000X
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3037819OtherBLUE CROSS BLUE SHIELD
TN3352553Medicaid
TN3352553Medicaid
TN3037819OtherBLUE CROSS BLUE SHIELD
U42075Medicare UPIN