MR. KIM LADELL LUSTER - NPI 1396870051

The NPI number for Kim Luster is 1396870051. It was assigned to this individual provider in the NPPES registry on February 22, 2007.

The NPPES record for Kim Luster was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mr. Kim Ladell Luster NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KIM LADELL LUSTER (NPI 1396870051) is an individual healthcare provider in Waukegan, Illinois and active in the NPI registry since February 2007.

NPI1396870051

Entity TypeIndividualMale

Primary Taxonomy246ZS0400X

Provider Legal NameMR. KIM LADELL LUSTER

Location Address2400 N SAMSON WAY, APT#2DWaukegan, IL 60087-5079

Mailing Address2400 N Samson Way, Apt#2dWaukegan, IL 60087-5079 · (122) 439-9931 · Fax (122) 494-4008

Fax(122) 494-4008

Sole ProprietorYes

Enumeration DateFebruary 22, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1396870051 is a valid, active identifier and passes the ISO check-digit test.

★ Primary Specialty

Taxonomy Code246ZS0400X

2400 N SAMSON WAY, Waukegan, IL 60087

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist/Technologist, Other (Surgical Technologist)

2400 N SAMSON WAY, APT#2D
WAUKEGAN, IL 60087

Lake County (122) 439-9931

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

The NPI number for Kim Luster is 1396870051. It was assigned to this individual provider in the NPPES registry on February 22, 2007.

Kim Luster practices at 2400 N Samson Way Apt#2d, Waukegan, IL 60087. The listed phone number is (122) 439-9931.

The NPPES record for Kim Luster was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.