Individual
TERRI LEE LYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
463 LOUDON RD, RIVERSIDE, IL 60546-1636
(708) 205-8668
Mailing address
463 LOUDON RD, RIVERSIDE, IL 60546-1636
(708) 205-8668
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
041.220223
IL
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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