Doctor Name: | DR. JEFF W LUCAS |
NPI Number: | 1053683565 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. MSW, LCPC,LMHC |
License Number: | 180000760 |
Business Practice Address: | 2 Mid America Plz Suite 800 Oakbrook Terrace, IL - 601814451 |
Business Phone Number: | 6309169926 |
Business Fax Number: | 6309169925 |
Mailing Address: | 2 Mid America Plz, Suite 800 OAKBROOK TERRACE |
State: | IL |
Postal Code: | 601814451 |
Phone Number: | 6309169926 |
Fax Number: | 6309169925 |
NPI Enumeration Date: | 01/30/2012 |
NPI Last Update Date: | 09/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TR0400X |
License Number: | 180000760 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |