Provider Demographics
NPI:1508038092
Name:PLATT, LOIS MARIE (APRN)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:MARIE
Last Name:PLATT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2230
Mailing Address - Country:US
Mailing Address - Phone:708-524-8145
Mailing Address - Fax:312-920-0770
Practice Address - Street 1:35 E WACKER DR
Practice Address - Street 2:STE 1764
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-2314
Practice Address - Country:US
Practice Address - Phone:708-524-8145
Practice Address - Fax:312-920-0770
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL309002017364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult