Provider Demographics
NPI:1649400458
Name:BISCHOF, LUCY A (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:A
Last Name:BISCHOF
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:A
Other - Last Name:BOKSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:840 S. WOOD
Mailing Address - Street 2:UNIVERSITY OF ILLINOIS ROOM B39 (M/C 735)
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-413-5897
Mailing Address - Fax:312-413-2685
Practice Address - Street 1:4838 N MAGNOLIA AVE
Practice Address - Street 2:APT 3B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-4744
Practice Address - Country:US
Practice Address - Phone:773-355-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.002544363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner