Provider Demographics
NPI:1043933187
Name:LUEBKE, AMY (DEM, OM,CNP,HHP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LUEBKE
Suffix:
Gender:F
Credentials:DEM, OM,CNP,HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-7687
Mailing Address - Country:US
Mailing Address - Phone:224-730-1940
Mailing Address - Fax:
Practice Address - Street 1:3910 DEAN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7687
Practice Address - Country:US
Practice Address - Phone:224-730-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwife
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No175M00000XOther Service ProvidersMidwife, LayGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoula