Provider Demographics
NPI:1619924396
Name:LAINO, NANNETTE (APN-CNP)
Entity Type:Individual
Prefix:MS
First Name:NANNETTE
Middle Name:
Last Name:LAINO
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:MS
Other - First Name:NANNETTE
Other - Middle Name:
Other - Last Name:LAINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN-CNP
Mailing Address - Street 1:6247 N KILPATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5070
Mailing Address - Country:US
Mailing Address - Phone:773-930-4538
Mailing Address - Fax:
Practice Address - Street 1:380 E NORTHWEST HWY
Practice Address - Street 2:STE. 240
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2290
Practice Address - Country:US
Practice Address - Phone:773-725-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209004552OtherPROFESSIONAL LICENSE
IL0347788-21OtherAPN CERTIFICATE
IL309001851OtherCONTROLLED SUBSTANCE
IL041150864OtherREGISTERED NURSE
IL041150864OtherREGISTERED NURSE
IL209004552OtherPROFESSIONAL LICENSE
ILP79504Medicare UPIN
IL0347788-21OtherAPN CERTIFICATE