| Doctor Name: | LORY JOANNA ARQUILLA-MALTBY |
| NPI Number: | 1205866373 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 209-004916 |
| Business Practice Address: | 7733 W Grand Ave Elmwood Park, IL - 607071820 |
| Business Phone Number: | 7084529200 |
| Business Fax Number: | |
| Mailing Address: | 921 Dunlop Ave, FOREST PARK |
| State: | IL |
| Postal Code: | 601302242 |
| Phone Number: | 7087718425 |
| Fax Number: | |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 03/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 209-004916 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |