Provider Demographics
NPI:1508575846
Name:MONK, NAOMI FAYE (APRN)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:FAYE
Last Name:MONK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 GLENARYE DR
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-7925
Mailing Address - Country:US
Mailing Address - Phone:847-989-7075
Mailing Address - Fax:
Practice Address - Street 1:173 E LAUREL AVE
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1205
Practice Address - Country:US
Practice Address - Phone:224-899-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL309.019567363LF0000X
IL209.026418363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily