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General NPI Number Information
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NPI Number | 1487286548
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Entity Type | Individual
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Provider Name | LISA KAY KRACINSKI APN
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Gender | Female
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 340 W BUTTERFIELD RD STE 3B
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City | ELMHURST
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State | IL
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Zip | 60126-5043
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Country | US
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Telephone | 630-869-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 10745 S HAMLIN AVE
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City | CHICAGO
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State | IL
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Zip | 60655-3914
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Country | US
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Telephone | 773-332-7343
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209020605
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209020605
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.020605
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License Number State | IL
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