Individual
KELLY C. LANNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CRNA
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2760
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2760
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
041.390796
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209.016942
IL
Other
Enumeration date
09/28/2017
Last updated
09/20/2022
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