Provider Demographics
NPI:1952906125
Name:LUX, ADAM SAMUEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SAMUEL
Last Name:LUX
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 S MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-5800
Mailing Address - Country:US
Mailing Address - Phone:217-528-4926
Mailing Address - Fax:
Practice Address - Street 1:424 S ADELIA ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-1632
Practice Address - Country:US
Practice Address - Phone:217-622-8068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.296633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist