Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Luchinni Prabowo-Mandayo

Individual provider Behavior Technician · NPI 1801623152

Luchinni Prabowo-Mandayo is a Behavior Technician in Park Ridge, Illinois. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

444 N Northwest Hwy Ste 147
Park Ridge, IL 60068-3263
Phone: (847) 610-9798
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1801623152
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 18, 2024
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024

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