MEDICARE: MRS. LYNNE KRASNY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	041232412	IL

General Provider Information

NPI Number	:	1700151677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNNE KRASNY

Provider Business Mailing Address
First Line	:	3010 GRAND AVE.
Second Line	:
City	:	WAUKEGAN
State	:	IL
Zip	:	60085-2321
Country	:	US
Telephone Number	:	847-377-7842
Fax Number	:	847-478-5517

Provider Business Practice Location Address
First Line	:	24647 N. MILWAUKEE
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-2321
Country	:	US
Telephone Number	:	847-377-7959
Fax Number	:	847-478-5517

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2012
Last Update Date	:	03/12/2012

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