Healthcare Provider Details

I. General information

NPI: 1891968921
Provider Name (Legal Business Name): PATRICIA JEAN LAMP ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 LARKIN AVE
ELGIN IL
60123-5827
US

IV. Provider business mailing address

9N624 NOKOMIS LN
ELGIN IL
60124-8429
US

V. Phone/Fax

Practice location:
  • Phone: 847-289-5727
  • Fax: 847-888-5469
Mailing address:
  • Phone: 847-697-1228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209003891
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: