=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558313221
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LORI L HARDY M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2006
-----------------------------------------------------
Last Update Date | 05/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 471 W ARMY TRAIL RD SUITE 103
-----------------------------------------------------
City | BLOOMINGDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60108-2628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-980-3366
-----------------------------------------------------
Fax | 630-980-3686
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 471 W ARMY TRAIL RD SUITE 103
-----------------------------------------------------
City | BLOOMINGDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60108-2673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-980-3366
-----------------------------------------------------
Fax | 630-980-3686
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 70209-20
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 036-108675
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------