| NPI | 1912507021 |
|---|---|
| Doing Business As | LUCID LANE PROVIDERS, P.C. |
| Entity Type | Organization |
| Authorized Contact | MUBEENA SIDDIQUI Director Of Rcm And Compliance 630-589-2730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC0700X Psychologist, Clinical | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 207R00000X Internal Medicine | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2021-01-29 |