Provider Demographics
NPI:1508696915
Name:BRUSCHUK, LUKE (MSW, LSW)
Entity type:Individual
Prefix:MR
First Name:LUKE
Middle Name:
Last Name:BRUSCHUK
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:977 LAKEVIEW PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1476
Mailing Address - Country:US
Mailing Address - Phone:847-906-0026
Mailing Address - Fax:
Practice Address - Street 1:977 LAKEVIEW PKWY STE 150
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1476
Practice Address - Country:US
Practice Address - Phone:847-906-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.113488104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker