Provider Demographics
NPI:1538530191
Name:LESSACK, MATTHEW PETER (MA)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PETER
Last Name:LESSACK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6032
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60204-6032
Mailing Address - Country:US
Mailing Address - Phone:224-259-2271
Mailing Address - Fax:833-806-2514
Practice Address - Street 1:814 MICHIGAN AVE APT 2W
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2544
Practice Address - Country:US
Practice Address - Phone:224-259-2271
Practice Address - Fax:833-806-2514
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health