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NPI Code Detail

MEDICARE: LYNDSEY M POWELL FNP-BC

MEDICARE: LYNDSEY M POWELL FNP-BC
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
1363LF0000XFamily Nurse Practitioner209.009975IL

General Provider Information

NPI Number : 1609120591
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDSEY M POWELL FNP-BC
Provider Business Mailing Address
First Line : 6150 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60660-2538
Country : US
Telephone Number : 630-334-2565
Fax Number :
Provider Business Practice Location Address
First Line : 6150 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60660-2538
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2012
Last Update Date : 08/29/2017

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