Provider Demographics
NPI:1689339491
Name:ATSAVES, LUCKIA
Entity Type:Individual
Prefix:
First Name:LUCKIA
Middle Name:
Last Name:ATSAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 VALENCIA DR APT 114
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-7034
Mailing Address - Country:US
Mailing Address - Phone:224-245-9793
Mailing Address - Fax:
Practice Address - Street 1:2150 VALENCIA DR APT 114
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-7034
Practice Address - Country:US
Practice Address - Phone:224-245-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor