Provider Demographics
NPI:1679704027
Name:LEMKE, ANDREA LYN
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYN
Last Name:LEMKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5828 N ODELL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3067
Mailing Address - Country:US
Mailing Address - Phone:847-912-9885
Mailing Address - Fax:
Practice Address - Street 1:5828 N ODELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3067
Practice Address - Country:US
Practice Address - Phone:847-912-9885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist