Provider Demographics
NPI:1790131365
Name:LUCHT, YARASLAVA (PHARMD)
Entity Type:Individual
Prefix:
First Name:YARASLAVA
Middle Name:
Last Name:LUCHT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 PALATINE RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1196
Mailing Address - Country:US
Mailing Address - Phone:847-202-9232
Mailing Address - Fax:847-202-1227
Practice Address - Street 1:1489 PALATINE RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-1196
Practice Address - Country:US
Practice Address - Phone:847-202-9232
Practice Address - Fax:847-202-1227
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist