Provider Demographics
NPI:1871103838
Name:TSENG, LUKE (PSYD)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:
Last Name:TSENG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0N461 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-3069
Mailing Address - Country:US
Mailing Address - Phone:217-417-4192
Mailing Address - Fax:
Practice Address - Street 1:2100 MANCHESTER RD STE 1510
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4561
Practice Address - Country:US
Practice Address - Phone:630-653-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108386103TC0700X
390200000X
IL071010597103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty