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General NPI Number Information
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NPI Number | 1548754039
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Entity Type | Individual
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Provider Name | LEROY MICHAEL LAMBEY
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Gender | Male
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 10 E 22ND ST STE 207
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City | LOMBARD
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State | IL
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Zip | 60148-6108
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Country | US
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Telephone | 630-656-1422
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Fax |
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Provider Business Mailing Address
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Address Line | 5901 N CICERO AVE STE 600
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City | CHICAGO
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State | IL
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Zip | 60646-5721
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Country | US
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Telephone | 773-545-9200
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209.022514
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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 | 209.017716
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License Number State | IL
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