Provider Demographics
NPI:1801587506
Name:ZERBE, LORI LYNNE (LAC)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:LYNNE
Last Name:ZERBE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 N CLAREMONT AVE APT GDN
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2053
Mailing Address - Country:US
Mailing Address - Phone:773-550-5566
Mailing Address - Fax:
Practice Address - Street 1:1509 S STATE ST FL 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2804
Practice Address - Country:US
Practice Address - Phone:773-550-5566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001624171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist