Individual
LORNA K. MACKEBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,CNP
Contact information
Practice address
12 HEALTH SERVICES DR, DEKALB, IL 60115-9637
(815) 756-4875
(815) 756-2944
Mailing address
12 HEALTH SERVICES DR, DEKALB, IL 60115-9637
(815) 756-4875
(815) 756-2944
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041190087
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209007571
IL
Other
Enumeration date
05/06/2009
Last updated
11/19/2013
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