# LORI ANN M MORENO APN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891185971
- **Authorized official:** MRS. LORI ANN MENDOZA MORENO APN (NURSE PRACTITIONER)
- **Authorized official phone:** (224) 306-1879

## Contact information

- **Practice address:** 60 REVERE DR, SUITE 100, NORTHBROOK, IL 60062-1563
- **Practice address phone:** (224) 306-1879
- **Mailing address:** 60 REVERE DR, SUITE 100, NORTHBROOK, IL 60062-1563

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 209009279 | IL | Yes |

## Other

- **Enumeration date:** 01/28/2015
- **Last updated:** 04/20/2015