Healthcare Provider Details

I. General information

NPI: 1790795474
Provider Name (Legal Business Name): LORRITA MARIE VERHEY APN,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 W. 47TH STREET SOUTH IHC
CHICAGO IL
60609
US

IV. Provider business mailing address

845 S. DAMEN AVE. SUITE 938
CHICAGO IL
60612-7350
US

V. Phone/Fax

Practice location:
  • Phone: 773-536-8400
  • Fax: 773-536-2406
Mailing address:
  • Phone: 312-996-8009
  • Fax: 312-996-7725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: