Provider Demographics
NPI:1770549420
Name:LUTRIN, FRANK J (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:LUTRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 WARRENVILLE RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515
Mailing Address - Country:US
Mailing Address - Phone:630-324-7900
Mailing Address - Fax:630-324-7942
Practice Address - Street 1:1405 W PARK ST
Practice Address - Street 2:SUITE 303
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801
Practice Address - Country:US
Practice Address - Phone:217-337-2924
Practice Address - Fax:217-337-2703
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095869208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
344390OtherDUPAGE GROUP
IL36095869Medicaid
202172OtherURBANA/ROCKFORD/MOLINE
526620OtherCOOK GROUP
G55500Medicare UPIN
344390OtherDUPAGE GROUP
526620OtherCOOK GROUP
IL36095869Medicaid