Provider Demographics
NPI:1912174970
Name:CATT, LUCAS L (MD)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:L
Last Name:CATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1005 HEALTH CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4693
Mailing Address - Country:US
Mailing Address - Phone:217-238-6055
Mailing Address - Fax:217-258-4063
Practice Address - Street 1:1005 HEALTH CENTER DR STE 103
Practice Address - Street 2:
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-4693
Practice Address - Country:US
Practice Address - Phone:217-258-4051
Practice Address - Fax:217-258-4063
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-121599207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine