Healthcare Provider Details

I. General information

NPI: 1659491702
Provider Name (Legal Business Name): MS. LUCY MUELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 S EXCHANGE AVE
CHICAGO IL
60649-2503
US

IV. Provider business mailing address

3106 N SAWYER AVE
CHICAGO IL
60618-6803
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-5700
  • Fax: 773-702-4144
Mailing address:
  • Phone: 773-588-0779
  • Fax: 773-702-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: