Provider Demographics
NPI:1336033240
Name:MASTAKA, ENEA
Entity type:Individual
Prefix:
First Name:ENEA
Middle Name:
Last Name:MASTAKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W RAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2359
Mailing Address - Country:US
Mailing Address - Phone:847-529-7677
Mailing Address - Fax:
Practice Address - Street 1:1137 MCHENRY RD STE 206
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1377
Practice Address - Country:US
Practice Address - Phone:847-807-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health