Provider Demographics
NPI:1164815684
Name:CAVOTO, LORAINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LORAINE
Middle Name:
Last Name:CAVOTO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 SHAKESPEARE LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4117
Mailing Address - Country:US
Mailing Address - Phone:630-718-1105
Mailing Address - Fax:
Practice Address - Street 1:13550 S ROUTE 30
Practice Address - Street 2:SUITE 100
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5685
Practice Address - Country:US
Practice Address - Phone:815-436-1655
Practice Address - Fax:815-436-1656
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.012231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily