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NPI 1043930795

NPI 1043930795 : LORNA SIEGER FNP : BOURBONNAIS, IL

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General NPI Number Information
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    NPI Number           |    1043930795
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    Entity Type          |    Individual 
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    Provider Name        |    LORNA SIEGER FNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/01/2022
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    Last Update Date     |    09/01/2022
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Provider Practice Location Address
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    Address Line         |    2070 IL-50 #500 
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    City                 |    BOURBONNAIS
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    State                |    IL
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    Zip                  |    60914
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    Country              |    US
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    Telephone            |    779-236-4094
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1342 RAINBOW CIR 
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    City                 |    MANTENO
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    State                |    IL
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    Zip                  |    60950-9414
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    Country              |    US
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    Telephone            |    815-207-1383
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    209025858
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    License Number State |    IL
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