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Individual

NICOLE LASAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
3002 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8278
Mailing address
841 MOCKING BIRD DR, ANTIOCH, IL 60002-2726
(847) 377-8278
(847) 984-5676

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
041404276
IL

Other

Enumeration date
08/30/2017
Last updated
08/30/2017
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