TIFFANY LAKE-LUCKETT NPI 1538808100

NPI Information

  • NPI: 1538808100
  • Provider Name: TIFFANY LAKE-LUCKETT
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2340 S EOLA RD STE 100
    AURORA, IL
    ZIP 60503
  • Phone: (630) 692-5190

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NPI Details

Tiffany Lake-luckett is a family nurse practitioner in Aurora, IL. Tiffany Lake-luckett NPI is 1538808100. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2340 S EOLA RD STE 100
AURORA, IL
ZIP 60503-410
Phone: (630) 692-5190
Fax: (630) 692-5185

The NPI 1538808100 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/1/2022 and was last updated on 9/9/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily209.025453ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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