Healthcare Provider Details

I. General information

NPI: 1821391640
Provider Name (Legal Business Name): LYNNE ANNETTE SCHWEPPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNNE ANNETTE MUNDY MAIDEN NAME

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 S GALENA AVE
FREEPORT IL
61032
US

IV. Provider business mailing address

PO BOX 813
FREEPORT IL
61032-0813
US

V. Phone/Fax

Practice location:
  • Phone: 815-391-1000
  • Fax: 815-720-4950
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.018610
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number041291775
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number309003730
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: