Individual
MS. LIDIA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2760
Mailing address
1725 W HARRISON ST STE 1156, CHICAGO, IL 60612-3852
(312) 563-2762
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021475
IL
363LA2100X
Acute Care Nurse Practitioner
2020027221
MO
363LA2100X
Acute Care Nurse Practitioner
209.021475
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420089045
—
MO
Enumeration date
08/07/2020
Last updated
04/29/2022
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