Healthcare Provider Details

I. General information

NPI: 1437481843
Provider Name (Legal Business Name): ELENA VILIA TUSKENIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18700 WOLF RD STE 230
MOKENA IL
60448-8764
US

IV. Provider business mailing address

18700 WOLF RD STE 230
MOKENA IL
60448-8764
US

V. Phone/Fax

Practice location:
  • Phone: 801-541-2818
  • Fax:
Mailing address:
  • Phone: 801-541-2818
  • Fax: 801-541-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036129014
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number57203-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: