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NPI Code Detail

MEDICARE: LORNA STEPHANIE COLLINS

MEDICARE: LORNA STEPHANIE COLLINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1215553672
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORNA STEPHANIE COLLINS
Provider Business Mailing Address
First Line : 3333 GREEN BAY RD
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-3095
Country : US
Telephone Number : 508-344-0900
Fax Number :
Provider Business Practice Location Address
First Line : 3333 GREEN BAY RD
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-3095
Country : US
Telephone Number : 508-344-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2020
Last Update Date : 06/22/2020

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Directions to “ LORNA STEPHANIE COLLINS ” Practice Location

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