Individual
EBONY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3007 BERNICE RD, LANSING, IL 60438-1243
(312) 826-6277
Mailing address
3007 BERNICE RD, LANSING, IL 60438-1243
(312) 826-6277
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
22020493626L
IL
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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