Provider Demographics
NPI:1750697462
Name:FARRELL, LYNNE DEE (RN)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:DEE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 N RANDALL RD
Mailing Address - Street 2:SUITE # 309
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2306
Mailing Address - Country:US
Mailing Address - Phone:847-741-7990
Mailing Address - Fax:847-741-8099
Practice Address - Street 1:1435 N RANDALL RD
Practice Address - Street 2:SUITE # 309
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2306
Practice Address - Country:US
Practice Address - Phone:847-741-7990
Practice Address - Fax:847-741-8099
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-266395163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse