Provider Demographics
NPI:1730466988
Name:DAFLUCAS, ESTHER RUTH (MA)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:RUTH
Last Name:DAFLUCAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 BURDETTE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-3365
Mailing Address - Country:US
Mailing Address - Phone:630-942-1020
Mailing Address - Fax:
Practice Address - Street 1:200 E WILLOW AVE STE 101
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5441
Practice Address - Country:US
Practice Address - Phone:630-881-7553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional