Healthcare Provider Details

I. General information

NPI: 1891997540
Provider Name (Legal Business Name): LYNETTE C CONNELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 PARK AVE W
HIGHLAND PARK IL
60035-2433
US

IV. Provider business mailing address

2500 RIDGE AVE # 1223
EVANSTON IL
60201-2455
US

V. Phone/Fax

Practice location:
  • Phone: 847-926-5840
  • Fax: 847-926-5835
Mailing address:
  • Phone: 847-570-2040
  • Fax: 847-733-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036116280
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036116280
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: