| Doctor Name: | LUTHER CAMPBELL |
| NPI Number: | 1134559222 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 178009585 |
| Business Practice Address: | 100 N Waukegan Rd Suite 204 Lake Bluff, IL - 600441694 |
| Business Phone Number: | 2245449167 |
| Business Fax Number: | |
| Mailing Address: | 100 N Waukegan Rd, Suite 204 LAKE BLUFF |
| State: | IL |
| Postal Code: | 600441694 |
| Phone Number: | 2245449167 |
| Fax Number: | |
| NPI Enumeration Date: | 11/26/2013 |
| NPI Last Update Date: | 11/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 178009585 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |