Provider Demographics
NPI:1720786239
Name:STANTON, VERONICA LORRAINE (DNP, PNP - PC)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:LORRAINE
Last Name:STANTON
Suffix:
Gender:F
Credentials:DNP, PNP - PC
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:LORRAINE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1559 N MCKINLEY RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1377
Mailing Address - Country:US
Mailing Address - Phone:847-877-2890
Mailing Address - Fax:
Practice Address - Street 1:1220 HOBSON RD STE 232
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8138
Practice Address - Country:US
Practice Address - Phone:630-946-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209026176363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics