Provider Demographics
NPI:1568981561
Name:LYONS, SARAH (APN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LYONS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CADILLAC CT STE 7
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-1733
Mailing Address - Country:US
Mailing Address - Phone:815-544-0087
Mailing Address - Fax:815-544-0088
Practice Address - Street 1:205 CADILLAC CT STE 7
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-1733
Practice Address - Country:US
Practice Address - Phone:815-544-0087
Practice Address - Fax:815-544-0088
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016535207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1942219514OtherYOUR FAMILY DOCTOR