Individual
DIANE L DUDDLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
660 N. WESTMORELAND ROAD, LAKE FOREST EMERGENCY DEPT, LAKE FOREST, IL 60045-1659
(847) 535-6150
(847) 535-7801
Mailing address
600 N WESTMORELAND RD, EMERGENCY DEPARTMENT, LAKE FOREST, IL 60045-1659
(847) 535-6150
(847) 535-7801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209001910
IL
363LA2100X
Acute Care Nurse Practitioner
Primary
209-001910
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00417654
RAILROAD MCR
—
Enumeration date
07/13/2006
Last updated
04/20/2010
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