Provider Demographics
NPI:1952323693
Name:LOKOS, CONSTANCE REID (ADVANCE PRACTICE NUR)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:REID
Last Name:LOKOS
Suffix:
Gender:F
Credentials:ADVANCE PRACTICE NUR
Other - Prefix:MS
Other - First Name:CONSTANCE
Other - Middle Name:ANNE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GERIATRIC NURSE PRAC
Mailing Address - Street 1:207 CAROL ANN DR
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-6893
Mailing Address - Country:US
Mailing Address - Phone:630-372-8262
Mailing Address - Fax:630-830-8574
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:STE 605 EBERLE BUILDING
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3397
Practice Address - Country:US
Practice Address - Phone:847-364-6724
Practice Address - Fax:847-364-6720
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S67648Medicare UPIN
S67648Medicare ID - Type Unspecified