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TIFFANY LAKE-LUCKETT
NPI 1538808100
Nurse Practitioner - Family in Aurora, IL

Active since June 01, 2022
2340 S EOLA RD STE 100, AURORA, IL 60503(630) 692-5190(630) 692-5185 Get Directions Write a Review

NPPES record last updated: September 9, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 9, 2022, Jul 26, 2022, Jul 20, 2022 (3 updates tracked since 2022).

About Tiffany Lake-luckett NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFFANY LAKE-LUCKETT (NPI 1538808100) is an individual family provider in Aurora, Illinois, licensed in Illinois (209.025453) and active in the NPI registry since June 2022. She maintains a secondary practice location in Aurora.

NPPES Registry Identity

NPI1538808100
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTIFFANY LAKE-LUCKETT
Location Address2340 S EOLA RD STE 100Aurora, IL 60503-6410
Mailing Address2340 S Eola Rd Ste 100Aurora, IL 60503-6410 · (630) 692-5190 · Fax (630) 692-5185
Phone(630) 692-5190
Fax(630) 692-5185
Sole ProprietorNo
Enumeration DateJune 1, 2022
Last NPPES UpdateSeptember 9, 20223 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2022
✔ NPI 1538808100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.025453
2340 S EOLA RD STE 100, Aurora, IL 60503
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Secondary Practice Location 1

Location 1400 N Highland AveAurora, IL 60506-3814 · Phone (630) 978-2532

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiffany Lake-luckett's NPI number?

The NPI number for Tiffany Lake-luckett is 1538808100. It was assigned to this individual provider in the NPPES registry on June 1, 2022.

Where is Tiffany Lake-luckett located?

Tiffany Lake-luckett practices at 2340 S Eola Rd Ste 100, Aurora, IL 60503. The listed phone number is (630) 692-5190.

What is Tiffany Lake-luckett's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Tiffany Lake-luckett was last updated on September 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.