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General NPI Number Information
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NPI Number | 1639685134
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Entity Type | Individual
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Provider Name | LISA MARIE LORING FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2501 CHATHAM RD STE N
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4188
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Country | US
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Telephone | 815-781-2608
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Fax | 815-604-8044
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Provider Business Mailing Address
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Address Line | 12250 SINNETT ST
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City | HUNTLEY
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State | IL
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Zip | 60142-6005
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Country | US
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Telephone | 815-915-1088
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Fax | 815-604-8044
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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 | 277.003559
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041382958
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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 | 209.017246
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License Number State | IL
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