Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | IL |
NPI | 1003837451 |
---|---|
Provider Name | Ms. Joan Marie Lokar |
First Address | Chicago, IL 60614-3813 |
Second Address | Chicago, IL 61614-3394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7221 | (05) | IL |