Individual
MS. KELLY LYDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
800 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3361
(847) 981-3599
Mailing address
255 N ADDISON AVE APT 439, ELMHURST, IL 60126-1629
(773) 503-7230
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021740
IL
363LF0000X
Family Nurse Practitioner
209.02174
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.021740
APN LICENSE NUMBER
IL
Enumeration date
08/27/2020
Last updated
04/10/2026
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