Provider Demographics
NPI:1811174048
Name:RIGIEL, LUKE JOHN (DPT)
Entity type:Individual
Prefix:MR
First Name:LUKE
Middle Name:JOHN
Last Name:RIGIEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:10078 LAPEER RD
Practice Address - Street 2:SUITE B
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-9031
Practice Address - Country:US
Practice Address - Phone:810-653-6200
Practice Address - Fax:810-653-6226
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4797005Medicaid
MI0B81114OtherBCBS
MI4797005Medicaid
MIN69750007Medicare PIN