Healthcare Provider Details

I. General information

NPI: 1982980314
Provider Name (Legal Business Name): SUZANNE LARA HOLLAND FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE DALBY APN

II. Dates (important events)

Enumeration Date: 10/31/2011
Last Update Date: 02/01/2026
Certification Date: 02/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N 2ND ST
ROCHELLE IL
61068-1717
US

IV. Provider business mailing address

111 W JACKSON BLVD STE 1700
CHICAGO IL
60604-3597
US

V. Phone/Fax

Practice location:
  • Phone: 815-562-2181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209009205
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: