Provider Demographics
NPI:1376183467
Name:LEHN, MICHELLE R (FNP-BC, FPA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:R
Last Name:LEHN
Suffix:
Gender:F
Credentials:FNP-BC, FPA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:390 E CONGRESS PKWY STE I
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-6207
Mailing Address - Country:US
Mailing Address - Phone:312-513-2496
Mailing Address - Fax:
Practice Address - Street 1:390 E CONGRESS PKWY STE I
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6207
Practice Address - Country:US
Practice Address - Phone:312-513-2496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.020398363LF0000X
IL277.002551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily