Healthcare Provider Details

I. General information

NPI: 1780400911
Provider Name (Legal Business Name): NICHOLAS JAMES LUKA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 N WILKE RD STE 106
ARLINGTON HEIGHTS IL
60004-0003
US

IV. Provider business mailing address

4241 MEADOW VIEW DR
ST CHARLES IL
60175-5666
US

V. Phone/Fax

Practice location:
  • Phone: 224-300-4268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number085010962
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085010962
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: