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Individual

LORI R. ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.R.N.A.

Contact information

Practice address
2202 HARLEM RD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Mailing address
2202 HARLEM RD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041191136
IL
163W00000X
Registered Nurse
100815-030
WI
367500000X
Certified Registered Nurse Anesthetist
209-000340
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209000340
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
430075651
RAILROAD MEDICARE
Enumeration date
08/17/2006
Last updated
05/16/2017
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