Provider Demographics
NPI:1912799974
Name:LUMICLINICS PLLC
Entity type:Organization
Organization Name:LUMICLINICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARVET
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:847-769-4500
Mailing Address - Street 1:2700 PATRIOT BLVD,
Mailing Address - Street 2:STE 250
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8021
Mailing Address - Country:US
Mailing Address - Phone:847-769-4500
Mailing Address - Fax:
Practice Address - Street 1:2700 PATRIOT BLVD,
Practice Address - Street 2:STE 250
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8021
Practice Address - Country:US
Practice Address - Phone:847-769-4500
Practice Address - Fax:847-787-1740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care