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General NPI Number Information
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NPI Number | 1730197906
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Entity Type | Individual
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Provider Name | LORNA RIVERA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 4100 VETERANS PKWY
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City | MCHENRY
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State | IL
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Zip | 60050-4029
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Country | US
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Telephone | 815-385-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 VETERANS PKWY
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City | MCHENRY
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State | IL
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Zip | 60050-4029
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 036107036
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036107036
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License Number State | IL
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