MEDICARE: LINDSAY R. KAISER NP-C

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	209013882	IL

General Provider Information

NPI Number	:	1942661418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY R. KAISER NP-C

Provider Business Mailing Address
First Line	:	1025 S 6TH ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62703-2403
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 W MORTON AVE
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-3152
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:

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

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	03/11/2016

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