MEDICARE: LINDSEY NOELLE TERNING NP

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
1	363LF0000X	Family Nurse Practitioner	277001916	IL
2	163W00000X	Registered Nurse	041389252	IL

General Provider Information

NPI Number	:	1700383338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY NOELLE TERNING NP

Provider Business Mailing Address
First Line	:	540 POPLAR AVE
Second Line	:
City	:	ANTIOCH
State	:	IL
Zip	:	60002-3124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 S MILWAUKEE AVE
Second Line	:
City	:	LAKE VILLA
State	:	IL
Zip	:	60046-9471
Country	:	US
Telephone Number	:	224-627-9155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	03/24/2024

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