Provider Demographics
NPI:1427290055
Name:JAKUBOWSKI, LUKE A (MD)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:A
Last Name:JAKUBOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2530 CHICAGO AVENUE SOUTH
Mailing Address - Street 2:CHILDRENS SPECIALTY CENTER SUITE 450
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404
Mailing Address - Country:US
Mailing Address - Phone:612-874-1292
Mailing Address - Fax:
Practice Address - Street 1:3011 S 56TH ST
Practice Address - Street 2:APT 11
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53219-3182
Practice Address - Country:US
Practice Address - Phone:608-359-6964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN59156207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology