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General NPI Number Information
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NPI Number | 1073846440
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Entity Type | Individual
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Provider Name | JUDY LAU CARINO MSN,ANP,PMHNP,APRN
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Gender | Female
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 210 N HAMMES AVE STE 205
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City | JOLIET
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State | IL
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Zip | 60435-8139
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Country | US
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Telephone | 815-729-7790
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Fax | 815-725-8144
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Provider Business Mailing Address
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Address Line | 800 BLACK RD
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City | JOLIET
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State | IL
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Zip | 60435-5942
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Country | US
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Telephone | 815-727-6667
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209004954
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209004954
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License Number State | IL
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