Healthcare Provider Details

I. General information

NPI: 1629697297
Provider Name (Legal Business Name): LYNDSEY DANIELLE DEUERLING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 E ROOSEVELT RD
LOMBARD IL
60148-4647
US

IV. Provider business mailing address

244 E ROOSEVELT RD
LOMBARD IL
60148-4647
US

V. Phone/Fax

Practice location:
  • Phone: 630-629-6298
  • Fax:
Mailing address:
  • Phone: 630-629-6298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209020119
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: