Provider Demographics
NPI:1710942636
Name:LUKAN, KARA LYNN (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:LYNN
Last Name:LUKAN
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 43RD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-8401
Mailing Address - Country:US
Mailing Address - Phone:309-743-2070
Mailing Address - Fax:309-743-2073
Practice Address - Street 1:5700 UNIVERSITY AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8224
Practice Address - Country:US
Practice Address - Phone:515-221-1621
Practice Address - Fax:515-221-1626
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00972174400000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI18344036Medicare Oscar/Certification