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General NPI Number Information
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NPI Number | 1801332473
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Entity Type | Individual
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Provider Name | LORRAINE GRIFFEN
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Gender | Female
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 3741 176TH ST
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-4824
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Country | US
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Telephone | 708-798-7175
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Fax |
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Provider Business Mailing Address
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Address Line | 3741 176TH ST
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-4824
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Country | US
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Telephone | 708-798-7175
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 043038515
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License Number State | IL
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