Individual
LYDIA K PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3715 MUNICIPAL DR, MCHENRY, IL 60050-5483
(815) 759-2306
Mailing address
CAPTAIN JAMES, A LOVELL FHCC, NORTH CHICAGO, IL 60064
(224) 610-3886
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.507872
IL
163W00000X
Registered Nurse
O41.507872
IL
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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