Provider Demographics
NPI:1407608086
Name:ANGUIANO MUNOZ, LAZARO (FNP-C)
Entity type:Individual
Prefix:
First Name:LAZARO
Middle Name:
Last Name:ANGUIANO MUNOZ
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAZARO
Other - Middle Name:
Other - Last Name:ANGUIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2438 BERRY ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-1407
Mailing Address - Country:US
Mailing Address - Phone:573-855-8538
Mailing Address - Fax:
Practice Address - Street 1:700 E OGDEN AVE STE 202
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1296
Practice Address - Country:US
Practice Address - Phone:630-789-9785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209030383363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine