Provider Demographics
NPI:1922547843
Name:PERREAULT, LYNDSEY (FNP-C)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:PERREAULT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1521
Mailing Address - Country:US
Mailing Address - Phone:847-475-2273
Mailing Address - Fax:847-535-7761
Practice Address - Street 1:870 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1521
Practice Address - Country:US
Practice Address - Phone:847-475-2273
Practice Address - Fax:847-535-7761
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015340363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily