Provider Demographics
NPI:1033609508
Name:GRADONE, LINDSEY (APN-ACNP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GRADONE
Suffix:
Gender:F
Credentials:APN-ACNP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:DIONNE
Other - Last Name:LEIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1607 E 50TH PL APT 3B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-6134
Mailing Address - Country:US
Mailing Address - Phone:512-913-1914
Mailing Address - Fax:
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041410049163W00000X
IL20917591363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse