Provider Demographics
NPI:1679466809
Name:LAZAR, STEPHANIE (FNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:LAZAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:NORFLEET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, APRN, FNP-C
Mailing Address - Street 1:2003 W FULTON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-2345
Mailing Address - Country:US
Mailing Address - Phone:773-677-9616
Mailing Address - Fax:
Practice Address - Street 1:2003 W FULTON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2345
Practice Address - Country:US
Practice Address - Phone:773-677-9616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.032419041.371190207KA0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy