Doctor Name: | LUANNE G LANE |
NPI Number: | 1619111457 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | 041268666 |
Business Practice Address: | 27401 W Highway 22 Suite 103 Lake Barrington, IL - 600105999 |
Business Phone Number: | 8473828900 |
Business Fax Number: | |
Mailing Address: | 1701 W Wise Rd, SCHAUMBURG |
State: | IL |
Postal Code: | 601933553 |
Phone Number: | 8478952902 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2009 |
NPI Last Update Date: | 04/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 041268666 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |