Healthcare Provider Details

I. General information

NPI: 1669036331
Provider Name (Legal Business Name): CORINNE SADECKI-LUND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2019
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date: 02/11/2026
Reactivation Date: 03/02/2026

III. Provider practice location address

13305 S RIDGELAND AVE
PALOS HEIGHTS IL
60463-1808
US

IV. Provider business mailing address

13305 S RIDGELAND AVE
PALOS HEIGHTS IL
60463-1808
US

V. Phone/Fax

Practice location:
  • Phone: 708-361-6714
  • Fax: 708-361-9514
Mailing address:
  • Phone: 708-361-6714
  • Fax: 708-361-9514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.01855
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number260933
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: